MEDICARE: FREDERIC WILLIAM STEARNS MD

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
1	207N00000X	Dermatology Physician	11891	OK

General Provider Information

NPI Number	:	1952390361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERIC WILLIAM STEARNS MD

Provider Business Mailing Address
First Line	:	8803 S 101ST EAST AVE
Second Line	:	SUITE 335
City	:	TULSA
State	:	OK
Zip	:	74133-5726
Country	:	US
Telephone Number	:	918-307-0215
Fax Number	:	918-250-7669

Provider Business Practice Location Address
First Line	:	8803 S 101ST EAST AVE
Second Line	:	STE 335
City	:	TULSA
State	:	OK
Zip	:	74133-5726
Country	:	US
Telephone Number	:	918-307-0215
Fax Number	:	918-250-7669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	04/20/2008

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