Johnson C. Gourd M.D.
Family Medicine Physician in Tulsa, OK(View on Map)
Full Name
Johnson C Gourd M.D.
NPI Number
1043264732
NPI Type
Individual Provider
Gender
Male
Enumeration Date
05/19/2006
Specialties
(Taxonomies)Licenses
State
Oklahoma
License Number
23087
Contact
Information
Purpose
Mailing
Location
Address
9912 E 21ST ST
9912 E 21ST ST
City
Tulsa
Tulsa
State
OK
OK
Postal Code
74129-1620
74129-1620
Country
US
US
Telephone Number
(918) 622-0641
(918) 622-0641
Identifiers
Identifier
200020000A
Identifier State
OK
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 04/11/2011
Provider Address
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