Provider Demographics
NPI:1346422037
Name:STEPHEN A KIRKPATRICK MD PC
Entity Type:Organization
Organization Name:STEPHEN A KIRKPATRICK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-333-7172
Mailing Address - Street 1:3400 SE FRANK PHILLIPS BLV
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74000-2443
Mailing Address - Country:US
Mailing Address - Phone:918-333-7172
Mailing Address - Fax:918-331-2449
Practice Address - Street 1:3400 SE FRANK PHILLIPS BLV
Practice Address - Street 2:SUITE 700
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74000-2443
Practice Address - Country:US
Practice Address - Phone:918-333-7172
Practice Address - Fax:918-331-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14318207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1007722050AMedicaid
OK800522033Medicare PIN