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Organization
STONE BLUFF MEDICAL, LLC
Active
Organization
STONE BLUFF MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN KELLEY (SOLE MEMBER)
(918) 633-0447
Entity
Organization
Contact information
Practice address
2028 MAHANEY AVE, TAHLEQUAH, OK 74464-5783
(918) 992-6050
(833) 763-2349
Mailing address
2028 MAHANEY AVE, TAHLEQUAH, OK 74464-5783
(918) 992-6050
(833) 763-2349
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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