Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | 2013021744 | MO |
Y | 207YP0228X | Pediatric Otolaryngology | 5501 | OK |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101017956 | MI |
NPI | 1518108711 |
---|---|
Provider Name | Dr. Steven Rance Dyer |
First Address | Tulsa, OK 74136-3361 |
Second Address | Tulsa, OK 74136-7818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2009 |
Last Update Date | 12/04/2018 |