Provider Demographics
NPI:1134142995
Name:CATES, MAX GAYLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:GAYLEN
Last Name:CATES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:220 SW 89TH
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-8857
Mailing Address - Country:US
Mailing Address - Phone:405-616-7070
Mailing Address - Fax:405-632-8495
Practice Address - Street 1:220 SW 89TH
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8857
Practice Address - Country:US
Practice Address - Phone:405-616-7070
Practice Address - Fax:405-632-8495
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2013-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK11775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100162210-DMedicaid