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NPI Code Detail

MEDICARE: MR. MICHAEL JAMES STANCLIFF PA-C

MEDICARE: MR. MICHAEL JAMES STANCLIFF PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant1868OK
2363A00000XPhysician Assistant1868OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112407602OTHERCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417287871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL JAMES STANCLIFF PA-C
Provider Business Mailing Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-722-9474
Fax Number : 405-722-9463
Provider Business Practice Location Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-722-9474
Fax Number : 405-722-9463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2010
Last Update Date : 04/06/2026

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