Organization Active NPI

Luis V Gorospe MD PC

  • Surgery Physician
  • Broken Arrow, OK
National Provider Identifier
1245428689
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
10249 Issued in OK
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

Updated by the provider on Jan 7, 2011

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)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
110112850BMedicaidOK

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.