Provider Demographics
NPI:1417484676
Name:SHOWALTER, ERIN NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 S HOUSTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-9005
Mailing Address - Country:US
Mailing Address - Phone:918-586-4522
Mailing Address - Fax:918-586-4531
Practice Address - Street 1:3686 GRANDVIEW PKWY STE 320
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3404
Practice Address - Country:US
Practice Address - Phone:205-971-5499
Practice Address - Fax:205-971-5438
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.2622207VX0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program