Provider Demographics
NPI:1962412999
Name:GILE, TERRY MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:MICHAEL
Last Name:GILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 S 103RD EAST AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-2445
Mailing Address - Country:US
Mailing Address - Phone:918-921-9700
Mailing Address - Fax:918-292-8263
Practice Address - Street 1:3840 S 103RD EAST AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-2445
Practice Address - Country:US
Practice Address - Phone:918-921-9700
Practice Address - Fax:918-292-8263
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2276207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100106360AMedicaid
OK241423602Medicare PIN
OK100106360AMedicaid