Individual
GEORGE KELLOGG STEPHENS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2017 W I 35 FRONTAGE RD, EDMOND, OK 73013-8504
(405) 757-3365
(405) 757-3498
Mailing address
4345 W MEMORIAL RD, STE 200, OKLAHOMA CITY, OK 73134-1702
(405) 936-5800
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15338
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100128790B
—
OK
Enumeration date
03/14/2006
Last updated
08/14/2014
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