Dorman, Gary A
Dorman, Gary A is an sole proprietor health care provider with primary practice located at 400 Fairview Ave Suite 21, Ponca City OK 74601-1922. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dorman, Gary A can be contacted via phone (580) 765-3356.Contact Information
Primary practice address
400 Fairview Ave Suite 21
Ponca City OK 74601-1922
Phone: (580) 765-3356
Fax: (580) 765-3353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1043 | Oklahoma |
Profile Details
| NPI number | 1467444315 |
|---|---|
| LBN Legal business name | Dorman, Gary A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2005 |
| Last updated | May 1st, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467444315 | NPPES |
| Oklahoma | MEDICAID | 100764410A | |
| Oklahoma | Other | 7311837180001 |
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