SCOTT STREET

BROKEN ARROW, OK
NPI1700014271
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: KS  7212)
Additional Taxonomies207Q00000X Family Medicine
(Licence: OK  5821)
Enumeration Date2009-06-23
Last Update Date2024-04-09
Business Address
SCOTT STREET DO
817 S ELM PL STE 106
BROKEN ARROW, OK 74012-5369
Phone number: 918-928-5437
Mailing Address
SCOTT STREET DO
1010 N. KANSAS WCGME
WICHITA, KS 67214
Phone number: 316-962-3030