GLENN ALAN KOESTER (NPI# 1790892461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790892461 |
| Entity Type | Individual |
| Full Name | GLENN ALAN KOESTER |
| Credential | MD |
| Practice Address |
3863 S. Boulevard Edmond OK 73034 |
| Practice Telephone | 4052165444 |
| Practice Fax Number | 4052165445 |
| Mailing Telephone | 4052165444 |
| Mailing Fax Number | 4052165445 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2013-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
18783 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100152170B | 05 |
| Street Address |
3863 S. BOULEVARD |
| City | EDMOND |
| State | OK |
| Zip Code | 73034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902930209 | Glenn Koester, M.d., P.C. | Dermatology | 3863 S Boulevard St Ste 200, Edmond, OK 73013-5540 | 2007-03-16 |
| 1285924837 | Graham Dermatology Center, P.C. | Dermatology | 307 E Danforth Rd, Suite 154, Edmond, OK 73034-4483 | 2011-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427436088 | Robert Clendenin | Dermatology | 432 N Broadway Ave, Shawnee, OK 74801-6922 | 2015-05-14 |
| 1710195003 | Travis Wayne Blalock | Dermatology | 619 Ne 13th St, Oklahoma City, OK 73104-5001 | 2007-05-18 |
| 1417007139 | Eric Wyatt | Dermatology | 104 Nw 31st St, Lawton, OK 73505-6100 | 2007-01-12 |
| 1457360646 | James Benton Stewart Jr. | Dermatology | 3705 W Memorial Rd, Suite 101, Oklahoma City, OK 73134-1512 | 2006-08-05 |
| 1982658167 | Abbott Dermatology P C | Dermatology | 3500 S Western Ave, Oklahoma City, OK 73109-2413 | 2006-05-20 |
| 1487621413 | Mary Melissa Morgan | Dermatology | 1621 S Eucalyptus Ave, Suite 202, Broken Arrow, OK 74012-5940 | 2006-03-08 |
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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.