Southern Oklahoma Ear Nose Throat and Allgery Clinic Inc

Primary specialty

Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X

License

20353 Issued in OK

Legal business name

SOUTHERN OKLAHOMA EAR NOSE THROAT AND ALLGERY CLINIC INC

Practice address

2002 12TH Ave NW
Suite D
Ardmore, OK 73401-1206

Phone

(580) 226-8646

Fax

(580) 226-8641

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Scott Allen Dempewolf, M.D.NPI 1437130762

Title

Owner

Phone

(580) 226-8646

Specialties & licenses 1

Addresses

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.

• Scott Allen Dempewolf, M.D.

  • Otolaryngic Allergy Physician
  • Ardmore, OK
  • NPI 1437130762
  Authorized official Same address or phone

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740233733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 12TH AVE NW",
            "address_2": "SUITE D",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011206",
            "telephone_number": "580-226-8646",
            "fax_number": "580-226-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 12TH AVE NW",
            "address_2": "SUITE D",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011206",
            "telephone_number": "580-226-8646",
            "fax_number": "580-226-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OKLAHOMA EAR NOSE THROAT AND ALLGERY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMPEWOLF",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-226-8646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "OK",
            "license": "20353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Otolaryngology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.