Provider Demographics
NPI:1538183421
Name:WEBB, GERALD MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:MATTHEW
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5700 ARNOLD ST
Mailing Address - Street 2:72 MDG/SGPF
Mailing Address - City:TINKER AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73145-8105
Mailing Address - Country:US
Mailing Address - Phone:405-736-2820
Mailing Address - Fax:405-736-2677
Practice Address - Street 1:117 NW 15TH ST
Practice Address - Street 2:APARTMENT #14
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-4630
Practice Address - Country:US
Practice Address - Phone:405-601-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01056851A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice