Provider Demographics
NPI:1588842694
Name:PALMER, STEPHEN KEITH (BUS)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:KEITH
Last Name:PALMER
Suffix:
Gender:M
Credentials:BUS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1404
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74502-1404
Mailing Address - Country:US
Mailing Address - Phone:918-423-6030
Mailing Address - Fax:918-423-2370
Practice Address - Street 1:628 E CREEK AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-6930
Practice Address - Country:US
Practice Address - Phone:918-423-6030
Practice Address - Fax:918-423-2370
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)