Doctor Name: | DR. NICASIO S GUTIERREZ |
NPI Number: | 1831281070 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14904 |
Business Practice Address: | 909 Alameda St Norman, OK - 730715229 |
Business Phone Number: | 4055733558 |
Business Fax Number: | 4055733962 |
Mailing Address: | 3616 Windover Dr, NORMAN |
State: | OK |
Postal Code: | 730723249 |
Phone Number: | 4053217388 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 14904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |