Provider Demographics
NPI:1205856820
Name:MIHALSKY, STEPHEN W (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:MIHALSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S BRYANT AVE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6399
Mailing Address - Country:US
Mailing Address - Phone:405-348-5060
Mailing Address - Fax:405-348-7508
Practice Address - Street 1:105 S BRYANT AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6399
Practice Address - Country:US
Practice Address - Phone:405-348-5060
Practice Address - Fax:405-348-7508
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK185722086S0105X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F59157Medicare UPIN
OK100022170AMedicaid