Individual
STEPHN DRYWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464
(918) 458-3100
Mailing address
PO BOX 1069, TAHLEQUAH, OK 74465-1069
(184) 535-7659
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
30727
OK
Other
Enumeration date
05/01/2014
Last updated
05/31/2018
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