Provider Demographics
NPI:1235237728
Name:HUMPHREY, MARY BETH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:BETH
Last Name:HUMPHREY
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:941 STANTON L YOUNG BLVD
Mailing Address - Street 2:BSEB 306E
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5019
Mailing Address - Country:US
Mailing Address - Phone:405-271-8001
Mailing Address - Fax:405-271-3191
Practice Address - Street 1:941 STANTON L YOUNG BLVD
Practice Address - Street 2:BSEB 306E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5019
Practice Address - Country:US
Practice Address - Phone:405-271-8001
Practice Address - Fax:405-271-3191
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OK25344207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology