MEDICARE: GARY JAMES BEEBY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231HA2400X	Assistive Technology Practitioner Audiologist	1	OK

General Provider Information

NPI Number	:	1871692988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY JAMES BEEBY

Provider Business Mailing Address
First Line	:	3130 N MADISON CT
Second Line	:
City	:	STILLWATER
State	:	OK
Zip	:	74075-1123
Country	:	US
Telephone Number	:	405-377-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	042 MURRAY HALL
Second Line	:
City	:	STILLWATER
State	:	OK
Zip	:	74078-5062
Country	:	US
Telephone Number	:	405-744-6021
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	12/16/2011

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Directions to “ GARY JAMES BEEBY ” Practice Location

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