Dermatology Associates of Oklahoma LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY ASSOCIATES OF OKLAHOMA LLC

Practice address

4805 S Western Ave
Oklahoma City, OK 73109-3835

Phone

(918) 492-6333

Fax

(918) 493-9405

NPI assigned

Dec 18, 2014

Last updated

Dec 18, 2014By 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

Robert Nevin

Title

Member

Phone

(918) 492-6333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1659779973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6966 S UTICA AVE",
            "address_2": "STE. 225",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363903",
            "telephone_number": "918-492-6333",
            "fax_number": "918-493-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093835",
            "telephone_number": "918-492-6333",
            "fax_number": "918-493-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "NEVIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-492-6333"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Deriks, PAC
• Derrick James Derksen, BA CADC CANDIDATE
• Derma Wound Care
• Dermatology Associates Inc
• Dermatology Associates of Oklahoma LLC
• Megan Dernaika, APRN
• Tarek A Dernaika, MD
• Brittany Dernbach
• Randel Derose, M.A., CCC-SLP
• Jonathan Derouen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.