| NPI | 1982658167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG LEON ABBOTT Physician 405-632-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology Dermatopathology (Licence: OK 17800) |
| Additional Taxonomies | 207NS0135X Dermatology Procedural Dermatology (Licence: OK 17800) |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: OK 17800) | |
| 207N00000X Dermatology (Licence: OK 17800) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-18 |