Gordon, Mary Burkhart

Gordon, Mary Burkhart is an individual health care provider with primary practice located at 1701 Renaissance Blvd , Edmond OK 73013-3086. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gordon, Mary Burkhart can be contacted via phone (405) 844-4978.

Contact Information

Primary practice address
1701 Renaissance Blvd Edmond OK 73013-3086
Fax: (405) 844-0562
Website:

Profile Details

NPI number 1821169590
LBN Legal business name Gordon, Mary Burkhart
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Feb 13th, 2024 - about last year

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 1821169590 NPPES
Other 6544 PHS PROVIDER NUMBER
Other P01137754 PHS PROVIDER NUMBER
MEDICAID 002828500 PHS PROVIDER NUMBER
Other 10001631801 PHS PROVIDER NUMBER
MEDICAID 427250709 PHS PROVIDER NUMBER
Other 500028442 PHS PROVIDER NUMBER
Other 511800 PHS PROVIDER NUMBER
Other 481202402 PHS PROVIDER NUMBER
MEDICAID 757385 PHS PROVIDER NUMBER
MEDICAID 100446630A PHS PROVIDER NUMBER

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