Gilmore, Owen Buck

Gilmore, Owen Buck is an individual health care provider with primary practice located at 100 S Bliss Ave , Tahlequah OK 74464-2512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gilmore, Owen Buck can be contacted via phone (918) 458-3100.

Contact Information

Primary practice address
100 S Bliss Ave Tahlequah OK 74464-2512
Phone: (918) 458-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21767 Oklahoma
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C-6488 Arkansas

Profile Details

NPI number 1194727198
LBN Legal business name Gilmore, Owen Buck
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194727198 NPPES
Oklahoma MEDICAID 100124330A
Oklahoma MEDICAID 110938001

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