Provider Demographics
NPI:1720350168
Name:STOOK, ELAINE EDITH (ELAINE STOOK)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:EDITH
Last Name:STOOK
Suffix:
Gender:F
Credentials:ELAINE STOOK
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:E
Other - Last Name:STOOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1120 S UTICA AVE
Mailing Address - Street 2:DEPARTMENT OF RADIATION ONCOLOGY
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4012
Mailing Address - Country:US
Mailing Address - Phone:918-579-8200
Mailing Address - Fax:
Practice Address - Street 1:1120 S UTICA AVE
Practice Address - Street 2:DEPARTMENT OF RADIATION ONCOLOGY
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4012
Practice Address - Country:US
Practice Address - Phone:918-579-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK836363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical