Provider Demographics
NPI:1962414904
Name:HALE, GERALD RAY (DO)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:RAY
Last Name:HALE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2448 E 81ST ST
Mailing Address - Street 2:SUITE 363
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4250
Mailing Address - Country:US
Mailing Address - Phone:918-477-5950
Mailing Address - Fax:918-477-5951
Practice Address - Street 1:2448 E 81ST ST
Practice Address - Street 2:SUITE 363
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4250
Practice Address - Country:US
Practice Address - Phone:918-477-5950
Practice Address - Fax:918-477-5951
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK2619208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100129900AMedicaid
OK100129900AMedicaid