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General NPI Number Information
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NPI Number | 1689809824
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Entity Type | Organization
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Legal Business Name | SCOTT NEWBROUGH MD PLLC
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 3824 S BOULEVARD ST SUITE 110
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City | EDMOND
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State | OK
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Zip | 73013-5478
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Country | US
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Telephone | 405-715-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 3824 S BOULEVARD ST SUITE 110
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City | EDMOND
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State | OK
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Zip | 73013-5478
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Country | US
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Telephone | 405-715-2227
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT ALAN NEWBROUGH
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Credential | M.D.
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Telephone | 405-715-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 26809
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License Number State | OK
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