Individual
DR. STEPHEN P ZACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 SW 89TH ST, OKLAHOMA CITY, OK 73159-7900
(405) 602-8100
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20192
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138260A
—
OK
01
—
P00422261
RR MEDICARE
—
Enumeration date
06/30/2006
Last updated
07/21/2022
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