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General NPI Number Information
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NPI Number | 1952667750
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Entity Type | Individual
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Provider Name | STEVEN CRAIG QUATTLEBAUM II M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 2017 W I 35 FRONTAGE RD STE 140
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City | EDMOND
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State | OK
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Zip | 73013-8555
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Country | US
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Telephone | 405-757-3710
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Fax | 405-757-3711
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Provider Business Mailing Address
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Address Line | 2017 W I 35 FRONTAGE RD STE 140
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City | EDMOND
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State | OK
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Zip | 73013-8555
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Country | US
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Telephone | 405-757-3710
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Fax | 405-757-3711
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 32897
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License Number State | OK
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