Search › Oklahoma › 2080P0006X
Edward Gustavson, MD
NPI 1386674182 · on the registry since 2006
Practice
- Address
- 1310 E Boone St
Tahlequah, OK 74464 - Phone
- (918) 456-7700
- Fax
- (918) 458-9314
- Organisation at this address
- Northeastern Oklahoma Community Health Centers Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 2080P0006X
2080P0006X
- Also registered as
- 208000000X
2080N0001X - Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-07-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma