STILLWATER DERMATOLOGY CLINIC (NPI# 1467487132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467487132 |
| Entity Type | Organization |
| Organization Name | STILLWATER DERMATOLOGY CLINIC |
| Practice Address |
1329 S Sangre Rd Stillwater OK 74074-1854 |
| Mailing Address |
Po Box 1583 Stillwater OK 74076-1500 |
| Practice Telephone | 4055333376 |
| Practice Fax Number | 4055332642 |
| Mailing Telephone | 4055333376 |
| Mailing Fax Number | 4055332642 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2017-01-06 |
| Authorized Official Name | THOMAS CARL HALL (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 4055333376 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 22869 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1329 S SANGRE RD |
| City | STILLWATER |
| State | OK |
| Zip Code | 74074-1854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174578280 | Thomas Carl Hall | Dermatology | 1329 S Sangre Rd, Stillwater, OK 74074-1854 | 2006-05-24 |
| 1629240148 | Metcalf Dermatology,plc | Specialist | 1329 S Sangre Rd, Stillwater, OK 74074-1854 | 2008-03-25 |
| 1881733780 | Sara K Metcalf | Dermatology | 1329 S Sangre Rd, Stillwater, OK 74074-1854 | 2007-02-06 |
| 1114957370 | Kenda Gale Baker | Physician Assistant | 1329 S Sangre Rd, Stillwater, OK 74074-1854 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090680 | Jason K. White, Ph.d., LLC | Psychologist | 807 S. Pine St., Stillwater, OK 74074 | 2019-08-29 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1881256691 | Shelly Lynn Green | Nurse Practitioner | 1321 W. 7th Street, Stillwater, OK 74074 | 2019-07-01 |
| 1811426273 | Judy Catlett | Case Manager/Care Coordinator | 800 E. 6th Str, Stillwater, OK 74074 | 2017-06-08 |
| 1518322296 | Abi Physical Therapy Services | Physical Therapist | 810 S. Walnut Street, Stillwater, OK 74074 | 2015-12-22 |
| 1366833451 | Connecting The Pieces | Case Management | 812 S Walnut, Stillwater, OK 74074 | 2015-02-10 |
| 1790122414 | Airie Flanagan | Doula | 2601 Gregory Ln, Stillwater, OK 74074 | 2013-06-04 |
| 1760720668 | Stillwater Histology LLC | Internal Medicine | 1301 W. 6th St, Suite 106, Stillwater, OK 74074 | 2013-01-28 |
| 1144570565 | Nikkie Jo Dunnigan | Counselor | 2322 W 7th, Stillwater, OK 74074 | 2012-09-13 |
| 1487889952 | Lynn B. Roberts | General Practice | 1321 W 7th St, Stillwater Community Health, Stillwater, OK 74074 | 2009-05-27 |
| Find all providers in zip 74074 | ||||
| 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 |
|---|---|---|---|---|
| 1982775029 | Christine Kay Markus | Dermatology | 1950 Curve Crest Blvd W Ste 100, Stillwater, MN 55082-6062 | 2006-11-12 |
| 1588609606 | Robert Allan Breedlove | Dermatology | 1604 W 8th Ave, Stillwater, OK 74074-4207 | 2006-06-20 |
| 1174578280 | Thomas Carl Hall | Dermatology | 1329 S Sangre Rd, Stillwater, OK 74074-1854 | 2006-05-24 |
| 1144486978 | Advanced Dermatology Care Medical Cosmetic and Surgery Pa | Dermatology | 1970 Northwestern Ave S, Suite 300, Stillwater, MN 55082 | 2008-07-31 |
| 1881733780 | Sara K Metcalf | Dermatology | 1329 S Sangre Rd, Stillwater, OK 74074-1854 | 2007-02-06 |
| 1558350488 | Stillwater Medical Group | Dermatology | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427543289 | At Home Dermatology | Dermatology | 2816 Lamond Hill Ave, Edmond, OK 73034-6978 | 2018-06-25 |
| 1205320579 | Leslie Rainbolt | Dermatology | 6821 Nw Grand Blvd, Oklahoma City, OK 73116-5413 | 2018-06-19 |
| 1285138032 | Saints Medical Group, LLC | Dermatology | 1440 N Mustang Road, Mustang, OK 73064-7214 | 2018-03-19 |
| 1871012955 | Ssm Health Care of Oklahoma Inc | Dermatology | 3400 S Douglas Blvd Ste 305, Oklahoma City, OK 73150-1018 | 2017-09-11 |
| 1124543145 | Ross C Hensley M. D., Inc. | Dermatology | 4417 W Gore Blvd Ste 7, Lawton, OK 73505-5978 | 2017-08-10 |
| 1801320106 | Epiphany Dermatology of Oklahoma, LLC | Dermatology | 6717 South Yale Avenue, Suite 101, Tulsa, OK 74136-3318 | 2017-04-13 |
| 1962869313 | Paige Elizabeth Beverly | Dermatology | 13100 N Western Ave Ste 301, Oklahoma City, OK 73114-1432 | 2016-01-15 |
| 1629479258 | Dermatology Associates of Oklahoma LLC | Dermatology | 3111 Azalea Park Dr, Muskogee, OK 74401-2284 | 2014-09-15 |
| 1447667613 | Janelle Marshall Pavlis | Dermatology | 800 W Boise Cir Ste 400, Broken Arrow, OK 74012 | 2014-07-18 |
| 1720325533 | Saints Medical Group, LLC | Dermatology | 9720 Broadway Extension, Oklahoma City, OK 73114 | 2013-01-14 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 74074 |
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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.