Organization
ABBOTT DERMATOLOGY P C
Active
Organization
ABBOTT DERMATOLOGY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG LEON ABBOTT M.D. (PHYSICIAN)
(405) 632-5565
Entity
Organization
Contact information
Practice address
3500 S WESTERN AVE, OKLAHOMA CITY, OK 73109-2413
(405) 632-5565
(405) 632-3538
Mailing address
3500 S WESTERN AVE, OKLAHOMA CITY, OK 73109-2413
(405) 632-5565
(405) 632-3538
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
17800
OK
207ND0101X
MOHS-Micrographic Surgery Physician
17800
OK
207ND0900X
Dermatopathology Physician
Primary
17800
OK
207NS0135X
Procedural Dermatology Physician
17800
OK
Other
Enumeration date
05/20/2006
Last updated
07/18/2007
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