# STILLWATER HISTOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760720668
- **Authorized official:** THOMAS A. SWAFFORD M.D. (CO-OWNER)
- **Authorized official phone:** (405) 372-2390

## Contact information

- **Practice address:** 1301 W. 6TH ST, SUITE 106, STILLWATER, OK 74074
- **Practice address phone:** (405) 372-2390
- **Practice address fax:** (405) 742-5706
- **Mailing address:** 1301 W. 6TH ST, SUITE 106, STILLWATER, OK 74074
- **Mailing address phone:** (405) 372-2390
- **Mailing address fax:** (405) 742-5706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | OK | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | OK | Yes |

## Other

- **Enumeration date:** 01/28/2013
- **Last updated:** 01/28/2013