Stillwater Dermatology Clinic

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

22869 Issued in OK

Legal business name

STILLWATER DERMATOLOGY CLINIC

Practice address

1329 S Sangre Rd
Stillwater, OK 74074-1854

Phone

(405) 533-3376

Fax

(405) 533-2642

NPI assigned

Jul 11, 2006

Last updated

Jan 6, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas Carl Hall, MDNPI 1174578280

Title

Physician/Owner

Phone

(405) 533-3376

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Carl Hall, MD

  • Dermatology Physician
  • Stillwater, OK
  • NPI 1174578280
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1467487132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1583",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740761500",
            "telephone_number": "405-533-3376",
            "fax_number": "405-533-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 S SANGRE RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740741854",
            "telephone_number": "405-533-3376",
            "fax_number": "405-533-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER DERMATOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "405-533-3376",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "22869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stillwater Chiropractic Clinic Inc
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• Stillwater Dental and Implants, LLC
• Stillwater Dental Associates
• Stillwater Dentistry & Braces
• Stillwater Domestic Violence Services, Inc.
• Stillwater Endodontics Darrell W. Daugherty, DDS,PC
• Stillwater Eyecare Center, P.L.L.C.
• Stillwater Eyewear LLC
• Stillwater Familycare LLC

• Dermatology Physician in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Dermatology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.