Basic Information
| Provider Information | |||||||||
| NPI: | 1891855722 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOOKLAHOMA P C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 511 WINDSOR DR | ||||||||
| Address2: | |||||||||
| City: | STILLWATER | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740746962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057070900 | ||||||||
| FaxNumber: | 4057073363 | ||||||||
| Practice Location | |||||||||
| Address1: | 511 WINDSOR DR | ||||||||
| Address2: | |||||||||
| City: | STILLWATER | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740746962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057070900 | ||||||||
| FaxNumber: | 4057073363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 08/13/2008 | ||||||||
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| AuthorizedOfficialLastName: | STUBBS | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | N. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4057070900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.