Provider Demographics
NPI:1285662890
Name:BIORATO, REBECCA G (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:G
Last Name:BIORATO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:14936 SW 65TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-9599
Mailing Address - Country:US
Mailing Address - Phone:405-256-5011
Mailing Address - Fax:405-256-5074
Practice Address - Street 1:731 E STATE HIGHWAY 152
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-4520
Practice Address - Country:US
Practice Address - Phone:405-256-5011
Practice Address - Fax:405-256-5074
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK32405OtherOBNDD
OK200036540BMedicaid
OK4174OtherLICENSE
OK200036540BMedicaid
OK32405OtherOBNDD