Provider Demographics
NPI:1568658607
Name:OKLAT, STEPHEN HENRY (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:HENRY
Last Name:OKLAT
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Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:1105 SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2345
Mailing Address - Country:US
Mailing Address - Phone:231-935-7514
Mailing Address - Fax:231-392-0039
Practice Address - Street 1:1105 SIXTH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2345
Practice Address - Country:US
Practice Address - Phone:231-935-7514
Practice Address - Fax:231-392-0039
Is Sole Proprietor?:No
Enumeration Date:2007-09-22
Last Update Date:2024-02-28
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Provider Licenses
StateLicense IDTaxonomies
MI5601005130363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant