Active NPI
Luis V Gorospe MD PC
- Surgery Physician
- Broken Arrow, OK
National Provider Identifier
1245428689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 10249
- Legal business name
- LUIS V GOROSPE MD PC
- Practice address
- 705 W Queens St
Broken Arrow, OK 74012-1767 - Phone
- (918) 252-2800
- Fax
- (918) 252-2888
- NPI assigned
- Oct 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Luis V Gorospe, MD
- Title
- Physician
- Phone
- (918) 252-2800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 10249 | OK | Primary |
Addresses
Primary practice location
705 W Queens St
Broken Arrow, OK 74012-1767
Mailing address
PO Box 35567
Triad Bank
Tulsa, OK 74153
Phone (918) 252-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110112850B | Medicaid | OK |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294358400000",
"number": "1245428689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35567",
"address_2": "TRIAD BANK",
"city": "TULSA",
"state": "OK",
"postal_code": "74153",
"telephone_number": "918-252-2800",
"fax_number": "918-252-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 W QUEENS ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740121767",
"telephone_number": "918-252-2800",
"fax_number": "918-252-2888"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUIS V GOROSPE MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-10",
"last_updated": "2011-01-07",
"status": "A",
"authorized_official_last_name": "GOROSPE",
"authorized_official_first_name": "LUIS",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "918-252-2800",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "OK",
"license": "10249",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110112850B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.