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EDWARD ERNEST GUSTAVSON MD
NPI 1386674182
Pediatrics - Developmental - Behavioral Pediatrics in Tahlequah, OK

Active since July 04, 2006
1310 E BOONE ST, TAHLEQUAH, OK 74464(918) 456-7700(918) 458-9314 Get Directions Write a Review

NPPES record last updated: July 29, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edward Ernest Gustavson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARD ERNEST GUSTAVSON MD (NPI 1386674182) is an individual developmental - behavioral pediatrics provider in Tahlequah, Oklahoma, licensed in Oklahoma (20370) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1386674182
Entity TypeIndividualMale
Primary Taxonomy2080P0006X
Provider Legal NameEDWARD ERNEST GUSTAVSONCredential: MD
Location Address1310 E BOONE STTahlequah, OK 74464-3338
Mailing Address1310 E Boone StTahlequah, OK 74464-3338 · (918) 456-7700 · Fax (918) 458-9314
Phone(918) 456-7700
Fax(918) 458-9314
Sole ProprietorNo
Enumeration DateJuly 4, 2006
Last NPPES UpdateJuly 29, 2013
✔ NPI 1386674182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in OK · 20370
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
Also ListedPediatricsTaxonomy 208000000X · License 20370 (OK)
Also ListedPediatrics · Neonatal-Perinatal MedicineTaxonomy 2080N0001X · License 20370 (OK)
1310 E BOONE ST, Tahlequah, OK 74464
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Other Identifiers 3

Medicaid100173510AOK
Medicare ID-Type Unspecified243531107
Medicare UPINB58270

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GARY LYNN GASTON M.D.
Pediatrics
1310 E BOONE ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-7700
MEGAN MELOTT MOSS DO
Pediatrics
1310 E BOONE ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-7700
KRISTI DAWN HANEY APRN
Nurse Practitioner (Family)
1310 E BOONE ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-7700
NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1310 E BOONE ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-7700
GENA POWERS
Nurse Practitioner (Pediatrics)
1310 E BOONE ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-7700
DR. NAVEED SIDDIQUE M.D.
Pediatrics
1310 E BOONE ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-7700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Gustavson's NPI number?

The NPI number for Edward Gustavson is 1386674182. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Edward Gustavson located?

Edward Gustavson practices at 1310 E Boone St, Tahlequah, OK 74464. The listed phone number is (918) 456-7700.

What is Edward Gustavson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

What insurance does Edward Gustavson accept?

Health plans from Medica list Edward Gustavson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edward Gustavson was last updated on July 29, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.