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NPI Code Detail

MEDICARE: MR. STEPHEN A FEUERBORN M.D.

MEDICARE: MR. STEPHEN A FEUERBORN M.D.
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
1208D00000XGeneral Practice Physician17432OK
2207Q00000XFamily Medicine Physician17432OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760441612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN A FEUERBORN M.D.
Provider Business Mailing Address
First Line : 2401 W WRANGLER BLVD
Second Line :
City : SEMINOLE
State : OK
Zip : 74868-1917
Country : US
Telephone Number : 405-382-3650
Fax Number : 405-382-6028
Provider Business Practice Location Address
First Line : 2401 W WRANGLER BLVD
Second Line :
City : SEMINOLE
State : OK
Zip : 74868-1917
Country : US
Telephone Number : 405-382-3650
Fax Number : 405-382-6028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 09/28/2022

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Directions to “ MR. STEPHEN A FEUERBORN M.D.” Practice Location

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