Provider Demographics
NPI:1457462574
Name:STECKLOW, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:STECKLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3613 NW 56TH ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4526
Mailing Address - Country:US
Mailing Address - Phone:405-949-5505
Mailing Address - Fax:405-949-0718
Practice Address - Street 1:3613 NW 56TH ST
Practice Address - Street 2:SUITE 320
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4526
Practice Address - Country:US
Practice Address - Phone:405-949-5505
Practice Address - Fax:405-949-0718
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK202472080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine