Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 5431 | OK |
NPI | 1972817054 |
---|---|
Provider Name | Dr. Scott P. Reeder |
First Address | Tulsa, OK 74104-4013 |
Second Address | Owasso, OK 74055-6638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2010 |
Last Update Date | 01/07/2021 |