Provider Demographics
NPI:1801969522
Name:KROMPECHER, STEPHEN J (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:KROMPECHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98535
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-8535
Mailing Address - Country:US
Mailing Address - Phone:919-420-7811
Mailing Address - Fax:919-420-7815
Practice Address - Street 1:1801 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-5145
Practice Address - Country:US
Practice Address - Phone:580-821-5346
Practice Address - Fax:580-821-5582
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2010-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK15427207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100042120AMedicaid
OK100042120AMedicaid
OK$$$$$$$$$Medicare PIN