Provider Demographics
NPI:1780651315
Name:FOSHEE, STACEY LYN (MD)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:LYN
Last Name:FOSHEE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:14024 QUAIL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1006
Mailing Address - Country:US
Mailing Address - Phone:405-419-8447
Mailing Address - Fax:405-419-7745
Practice Address - Street 1:3048 SW 89TH ST STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6359
Practice Address - Country:US
Practice Address - Phone:405-464-8819
Practice Address - Fax:405-692-6601
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2015-07-24
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Provider Licenses
StateLicense IDTaxonomies
OK17560207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF45600Medicare UPIN