MEDICARE: MATTHEW R. STANFIELD MD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	22616	OK

General Provider Information

NPI Number	:	1548287428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW R. STANFIELD MD, PC

Provider Business Mailing Address
First Line	:	3501 NW 63RD ST
Second Line	:	SUITE 500
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-2237
Country	:	US
Telephone Number	:	405-842-4022
Fax Number	:	405-842-4024

Provider Business Practice Location Address
First Line	:	3501 NW 63RD ST
Second Line	:	SUITE 500
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-2237
Country	:	US
Telephone Number	:	405-842-4022
Fax Number	:	405-842-4024

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MATTHEW RAY STANFIELD
Credential	:	MD
Telephone Number	:	405-842-4022

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	08/22/2020

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