STILLWATER SKIN & CANCER MEDICAL CLINIC INC NPI 1790839900

NPI Information

STILLWATER SKIN & CANCER MEDICAL CLINIC, INC is a specialist in Stillwater, OK. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. STILLWATER SKIN & CANCER MEDICAL CLINIC, INC NPI is 1790839900. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1604 W 8TH AVE
STILLWATER, OK
ZIP 74074-207
Phone: (405) 624-1077
Fax: (405) 377-2273

The provider's authorized official is Robert A Breedlove .
The authorized official title is Owner and has the following contact phone number (405) 624-1077.

The CLIA number assigned to this NPI record is 37D2207769 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/23/2007 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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