Provider Demographics
NPI:1053427815
Name:DEAN, ROBERT WILLIAM JR (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:DEAN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8210
Practice Address - Street 1:11610 N 137TH E AVE
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:OK
Practice Address - Zip Code:74021
Practice Address - Country:US
Practice Address - Phone:918-272-2247
Practice Address - Fax:918-272-6185
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-01-26
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Provider Licenses
StateLicense IDTaxonomies
OK2933207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE36617Medicare UPIN
OK8HD739Medicare ID - Type Unspecified