Provider Demographics
NPI:1659884765
Name:IYER, KRISTYNA LENEE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTYNA
Middle Name:LENEE
Last Name:IYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 S SANGRE RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1854
Mailing Address - Country:US
Mailing Address - Phone:405-533-3376
Mailing Address - Fax:405-533-1312
Practice Address - Street 1:1329 S SANGRE RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-1854
Practice Address - Country:US
Practice Address - Phone:405-533-3376
Practice Address - Fax:405-533-1312
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-10
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39829207ND0101X, 207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery