Provider Demographics
NPI:1750341616
Name:STEINBROOK, GARY L (DO)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:L
Last Name:STEINBROOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1501 N FLORENCE AVE
Mailing Address - Street 2:300
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3179
Mailing Address - Country:US
Mailing Address - Phone:918-343-8560
Mailing Address - Fax:918-348-8561
Practice Address - Street 1:1501 N FLORENCE AVE
Practice Address - Street 2:300
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3179
Practice Address - Country:US
Practice Address - Phone:918-343-8560
Practice Address - Fax:918-348-8561
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK2650207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100124830AMedicaid
OKA67702Medicare UPIN
OK389882YLV0Medicare PIN