Individual
SCOTT STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
817 S ELM PL STE 106, BROKEN ARROW, OK 74012-5369
(918) 928-5437
(888) 720-8944
Mailing address
1010 N. KANSAS, WCGME, WICHITA, KS 67214
(316) 962-3030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5821
OK
207Q00000X
Family Medicine Physician
Primary
7212
KS
Other
Enumeration date
06/23/2009
Last updated
04/09/2024
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