Glenn Koester, M.D., P.C.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

18783 Issued in OK

Legal business name

GLENN KOESTER, M.D., P.C.

Practice address

3863 S Boulevard St Ste 200
Edmond, OK 73013-5540

Phone

(405) 216-5444

NPI assigned

Mar 16, 2007

Last updated

Aug 22, 2020By 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

Glenn Koester, M.D.NPI 1790892461

Title

M.D.

Phone

(405) 216-5444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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.

• Glenn Alan Koester, MD

  • Procedural Dermatology Physician
  • Edmond, OK
  • NPI 1790892461
  Authorized official Same address or phone
• Andraya Gower, MD

  • Dermatology Physician
  • Oklahoma City, OK
  • NPI 1235636200
  NPD (past)
• Kelley L Reberry, PAC

  • Physician Assistant
  • Denver, CO
  • NPI 1710258579
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902930209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3863 S BOULEVARD ST STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135540",
            "telephone_number": "405-216-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3863 S BOULEVARD ST STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135540",
            "telephone_number": "405-216-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN KOESTER, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOESTER",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "405-216-5444",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OK",
            "license": "18783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND",
            "identifier": "456922202001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zane Glasgow
• Michael Lee Glass, MD
• Glaucoma Surgeons of Oklahoma PLLC
• Tyler W Glaze, O.D.
• Laurel Michelle Glendening, PT
• Gloria L. So-Lloyd, PH.D., P.C.
• Glostars LLC
• Calli Nicole Glover
• Jordan Glover
• Sarah Ann Glover, M.ED., LPC

• Procedural Dermatology Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Procedural Dermatology 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.