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General NPI Number Information
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NPI Number | 1467593152
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Entity Type | Individual
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Provider Name | STAVROS STAVRAKIS MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 920 STANTON L YOUNG BLVD WP 1130
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5020
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Country | US
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Telephone | 405-271-5963
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Fax |
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Provider Business Mailing Address
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Address Line | 940 STANTON L YOUNG BLVD BMSB 357
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24491
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 24491
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 24491
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License Number State | OK
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