Provider Demographics
NPI:1134108483
Name:PARKER, STEPHEN M (MD)
Entity Type:Individual
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First Name:STEPHEN
Middle Name:M
Last Name:PARKER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:STE 1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3310
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:918-488-6010
Practice Address - Street 1:2950 S ELM PL
Practice Address - Street 2:STE 260
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7877
Practice Address - Country:US
Practice Address - Phone:918-449-3700
Practice Address - Fax:918-449-3705
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2008-04-20
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Provider Licenses
StateLicense IDTaxonomies
OK11270207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD84314Medicare UPIN
OK$$$$$$$$$Medicare PIN