Provider Demographics
NPI:1336274893
Name:STANLEY R GAHRING MD PC
Entity Type:Organization
Organization Name:STANLEY R GAHRING MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH ANN
Authorized Official - Middle Name:-
Authorized Official - Last Name:GAHRING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-421-6690
Mailing Address - Street 1:4 E CLARK BASS BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4269
Mailing Address - Country:US
Mailing Address - Phone:918-421-6690
Mailing Address - Fax:918-421-6693
Practice Address - Street 1:4 E CLARK BASS BLVD
Practice Address - Street 2:STE 201
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4269
Practice Address - Country:US
Practice Address - Phone:918-421-6690
Practice Address - Fax:918-421-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24384208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKA80388Medicare UPIN