Healthcare Provider Details

I. General information

NPI: 1508838038
Provider Name (Legal Business Name): STEVEN ANDREW EGLESTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 LENAPE DR
NOWATA OK
74048-4403
US

IV. Provider business mailing address

1020 LENAPE DR
NOWATA OK
74048-4403
US

V. Phone/Fax

Practice location:
  • Phone: 918-273-7500
  • Fax:
Mailing address:
  • Phone: 918-273-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22585
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: