Provider Demographics
NPI:1003819939
Name:GELCZER, ROBERT K (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:GELCZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 NW 56TH ST.
Mailing Address - Street 2:SUITE C-40
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4455
Mailing Address - Country:US
Mailing Address - Phone:405-945-4741
Mailing Address - Fax:888-972-5320
Practice Address - Street 1:3433 NW 56TH ST.
Practice Address - Street 2:SUITE C-40
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4455
Practice Address - Country:US
Practice Address - Phone:405-945-4741
Practice Address - Fax:888-972-5320
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK208592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100040880BMedicaid
OKP00141278OtherRAILROAD MEDICARE
OKP00141278OtherRAILROAD MEDICARE
OKOKA101943Medicare PIN
OK249713006Medicare PIN
OK100040880BMedicaid
OK244421003Medicare ID - Type Unspecified
OK242419510Medicare ID - Type Unspecified
OKMDLPL021Medicare ID - Type Unspecified
OKRADIA117Medicare ID - Type Unspecified
OKP00440278Medicare PIN