Individual
STEVEN LOUIS FILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14295
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100259020A
—
OK
Enumeration date
11/21/2005
Last updated
09/14/2016
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