Healthcare Provider Details

I. General information

NPI: 1083996862
Provider Name (Legal Business Name): ERIKA DRIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E THOMAS AVE
STILLWATER OK
74075-2600
US

IV. Provider business mailing address

421 E THOMAS AVE
STILLWATER OK
74075-2600
US

V. Phone/Fax

Practice location:
  • Phone: 405-372-2202
  • Fax: 405-445-3780
Mailing address:
  • Phone: 405-372-2202
  • Fax: 405-445-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: