Provider Demographics
NPI:1699735399
Name:GAHRING, STANLEY R (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:R
Last Name:GAHRING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 E CLARK BASS BLVD
Mailing Address - Street 2:SUITE 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:
Practice Address - Street 1:4 E CLARK BASS BLVD
Practice Address - Street 2:SUITE 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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24384208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKA80388Medicare UPIN