SearchOklahomaDevelopmental - Behavioral Pediatrics Physician

Edward Gustavson, MD

NPI 1386674182 · on the registry since 2006

Practice

Address
1310 E Boone St
Tahlequah, OK 74464
Phone
(918) 456-7700
Fax
(918) 458-9314
Organisation at this address
Northeastern Oklahoma Community Health Centers Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
6

Registry record

Primary taxonomy
Developmental - Behavioral Pediatrics Physician
2080P0006X
Also registered as
Pediatrics Physician
Neonatal-Perinatal Medicine Physician
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2013-07-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma