Provider Demographics
NPI:1881632537
Name:RESSLER, GINA LYN (MD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:LYN
Last Name:RESSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:LYN
Other - Last Name:INCIARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 E 9TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5756
Mailing Address - Country:US
Mailing Address - Phone:405-341-6009
Mailing Address - Fax:
Practice Address - Street 1:1300 E 9TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5756
Practice Address - Country:US
Practice Address - Phone:405-341-6009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23096207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG63203Medicare UPIN