Organization
BESWICK DERMATOLOGY PC
Active
Organization
BESWICK DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY CLYNE BESWICK M.D., PH.D (PRESIDENT)
(214) 207-7063
Entity
Organization
Contact information
Practice address
3915 E 51ST ST, TULSA, OK 74135-3605
(918) 749-5714
(918) 749-5826
Mailing address
332 MEMORY LN, EDMOND, OK 73013-5116
(214) 207-7063
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
27111
OK
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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