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General NPI Number Information
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NPI Number | 1225068521
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Entity Type | Organization
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Legal Business Name | STEPHEN C. GAUTHIER M.D. PC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 6516 N OLIE AVE SUITE E
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7226
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Country | US
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Telephone | 405-286-5606
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Fax | 405-286-5607
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Provider Business Mailing Address
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Address Line | 6516 N OLIE AVE SUITE E
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7226
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Country | US
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Telephone | 405-286-5606
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Fax | 405-286-5607
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STEPHEN C. GAUTHIER
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Credential | M.D.
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Telephone | 405-842-3792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 21236
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License Number State | OK
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