Individual
DR. STEPHEN CARLOS MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 N FLORENCE AVE STE 250, CLAREMORE, OK 74017-3256
(918) 343-8513
(918) 341-7090
Mailing address
1501 N FLORENCE, STE 250, CLAREMORE, OK 74017-3256
(918) 343-8513
(918) 341-7090
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
20083
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100215260A
—
OK
Enumeration date
05/18/2006
Last updated
05/03/2014
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