Healthcare Provider Details
I. General information
NPI: 1083536502
Provider Name (Legal Business Name): STEADFAST MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 S 8TH ST
MCLOUD OK
74851-8588
US
IV. Provider business mailing address
6802 S OLYMPIA AVE STE 150
TULSA OK
74132-1852
US
V. Phone/Fax
- Phone: 918-906-9373
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHAD
PHILLIPS
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 918-906-9373