Provider Demographics
NPI:1205145752
Name:CARTLIDGE, GREGORY LANCE (MSW)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:LANCE
Last Name:CARTLIDGE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 S PAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7295
Mailing Address - Country:US
Mailing Address - Phone:918-268-0238
Mailing Address - Fax:
Practice Address - Street 1:3105 E SKELLY DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6358
Practice Address - Country:US
Practice Address - Phone:918-599-7404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program