Organization
SOUTHSIDE DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON FISCHER (OWNER)
(918) 760-0700
Entity
Organization
Contact information
Practice address
3300 S ASPEN AVE STE A, BROKEN ARROW, OK 74012-7501
(918) 760-0700
Mailing address
6966 S UTICA AVE STE 225, TULSA, OK 74136-3903
(918) 492-6333
(918) 493-9405
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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