Gaston, Gary Lynn
Gaston, Gary Lynn is an sole proprietor health care provider with primary practice located at 1310 E Boone St , Tahlequah OK 74464-3338. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gaston, Gary Lynn can be contacted via phone (918) 456-7700.Contact Information
Primary practice address
1310 E Boone St
Tahlequah OK 74464-3338
Phone: (918) 456-7700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 12817 | Oklahoma |
Profile Details
| NPI number | 1134326564 |
|---|---|
| LBN Legal business name | Gaston, Gary Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Nov 16th, 2011 - about 13 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 | 1134326564 | NPPES |
| Oklahoma | MEDICAID | 110101250A |
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