Provider Demographics
NPI:1851467211
Name:STABLER, LARRY GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:GENE
Last Name:STABLER
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 1:4845 S SHERIDAN RD STE 509
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5719
Mailing Address - Country:US
Mailing Address - Phone:918-270-4309
Mailing Address - Fax:
Practice Address - Street 1:4845 S SHERIDAN RD STE 509
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5719
Practice Address - Country:US
Practice Address - Phone:918-270-4309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK10210OtherOK ST MED LIC
OK10210OtherOK ST MED LIC