Provider Demographics
NPI:1003813924
Name:GATTENBY, NOEL E (DO)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:E
Last Name:GATTENBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:STE 1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-369-3200
Mailing Address - Fax:918-369-3209
Practice Address - Street 1:8414 E 101ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6919
Practice Address - Country:US
Practice Address - Phone:918-369-3200
Practice Address - Fax:918-369-3209
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK3573208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100107770AMedicaid