Healthcare Provider Details

I. General information

NPI: 1326520214
Provider Name (Legal Business Name): STACEY L FOSHEE MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 89TH ST
OKLAHOMA CITY OK
73159-7900
US

IV. Provider business mailing address

PO BOX 720631
NORMAN OK
73070-4475
US

V. Phone/Fax

Practice location:
  • Phone: 405-419-8400
  • Fax:
Mailing address:
  • Phone: 405-292-5500
  • Fax: 405-292-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STACEY L FOSHEE
Title or Position: OWNER
Credential: M.D.
Phone: 405-464-8819