Provider Demographics
NPI:1336114461
Name:BELFORD, GUY PATRICK (MD)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:PATRICK
Last Name:BELFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:918-540-7788
Mailing Address - Fax:918-540-7786
Practice Address - Street 1:310 2ND AVE SW
Practice Address - Street 2:STE 203
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6743
Practice Address - Country:US
Practice Address - Phone:918-540-7788
Practice Address - Fax:918-540-7786
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200468380MMedicaid
OKDA1415OtherRR MEDICARE GROUP
OK100134770DMedicaid
OK100134770DMedicaid
OK298815YKW9Medicare PIN
D34385Medicare UPIN
OK200468380MMedicaid