MEDICARE: DR. GAIL RENEE MARCHANT

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	208D00000X	General Practice Physician	3274	OK

General Provider Information

NPI Number	:	1902396294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL RENEE MARCHANT

Provider Business Mailing Address
First Line	:	8784 E 105TH CT
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-7063
Country	:	US
Telephone Number	:	918-369-2396
Fax Number	:

Provider Business Practice Location Address
First Line	:	8784 E 105TH CT
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-7063
Country	:	US
Telephone Number	:	918-369-2396
Fax Number	:

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

Provider Enumeration Date	:	05/13/2018
Last Update Date	:	05/13/2018

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Directions to “ DR. GAIL RENEE MARCHANT ” Practice Location

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