Provider Demographics
NPI:1790398758
Name:PAXTON, STEPHEN WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:PAXTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:PAXTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7614 E 91ST ST STE 160
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6047
Mailing Address - Country:US
Mailing Address - Phone:918-459-0333
Mailing Address - Fax:
Practice Address - Street 1:7614 E 91ST ST STE 160
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6047
Practice Address - Country:US
Practice Address - Phone:918-459-0333
Practice Address - Fax:918-459-8880
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14407111N00000X
OK4377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor