SKIN SURGERY CENTER OF OKLAHOMA, P.C. (NPI# 1407180748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407180748 |
| Entity Type | Organization |
| Organization Name | SKIN SURGERY CENTER OF OKLAHOMA, P.C. |
| Practice Address |
5701 N Portland Ave Ste 301 Oklahoma City OK 73112-1670 |
| Practice Telephone | 4059476647 |
| Mailing Telephone | 4059476647 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-30 |
| Authorized Official Name | BRANDON RHINEHART (PRESIDENT) |
| Authorized Official Telephone | 4059476647 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 4552 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
5701 N PORTLAND AVE STE 301 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-1670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205320579 | Leslie Rainbolt | Dermatology | 6821 Nw Grand Blvd, Oklahoma City, OK 73116-5413 | 2018-06-19 |
| 1871012955 | Ssm Health Care of Oklahoma Inc | Dermatology | 3400 S Douglas Blvd Ste 305, Oklahoma City, OK 73150-1018 | 2017-09-11 |
| 1962869313 | Paige Elizabeth Beverly | Dermatology | 13100 N Western Ave Ste 301, Oklahoma City, OK 73114-1432 | 2016-01-15 |
| 1720325533 | Saints Medical Group, LLC | Dermatology | 9720 Broadway Extension, Oklahoma City, OK 73114 | 2013-01-14 |
| 1770845729 | Saints Medical Group LLC | Dermatology | 13128 N Macarthur Blvd, Oklahoma City, OK 73142-3017 | 2012-06-14 |
| 1285954305 | Yaohan Lam | Dermatology | 2201 Sw 119th St Ste A, Oklahoma City, OK 73170-3438 | 2010-06-11 |
| 1356449086 | Otobia Gifty Dimson | Dermatology | 5005 N Pennsylvania Ave Ste 105, Oklahoma City, OK 73112-8886 | 2006-09-20 |
| 1750487880 | Dermatology Clinic Inc A Professional Corp | Dermatology | 5701 N Portland Ave Ste 310, Oklahoma City, OK 73112-1670 | 2006-09-16 |
| 1477564797 | Clarence L Wiley Sr. | Dermatology | 1211 N Shartel Ave Ste 407, Oklahoma City, OK 73103-2425 | 2006-08-11 |
| 1750390886 | Alfred Last | Dermatology | 3435 Nw 56th, Suite 1000, Oklahoma City, OK 73112 | 2006-08-07 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.