Gastorf, Melissa Ann

Gastorf, Melissa Ann is an individual health care provider with primary practice located at 1004 N 19Th Ave Building 2, Durant OK 74701-3016. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gastorf, Melissa Ann can be contacted via phone (580) 931-9135.

Contact Information

Primary practice address
1004 N 19Th Ave Building 2 Durant OK 74701-3016
Fax: (580) 931-9161
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4074 Oklahoma

Profile Details

NPI number 1164426847
LBN Legal business name Gastorf, Melissa Ann
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jan 3rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164426847 NPPES
Oklahoma MEDICAID 200069300A

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