Organization · NPI-2

Abbott Dermatology P C

Dermatology, Dermatopathology · Oklahoma City, OK

NPI number1982658167
StatusActive
Last updated in NPPESJul 18, 2007

Details

NPI
1982658167
Entity type
Organization (NPI-2)
Legal business name
Abbott Dermatology P C
Organization subpart
No
Enumeration date
May 20, 2006
Last updated
Jul 18, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207ND0900X Dermatology, Dermatopathology17800OKYes
207NS0135X Dermatology, Procedural Dermatology17800OK
207ND0101X Dermatology, MOHS-Micrographic Surgery17800OK
207N00000X Dermatology17800OK

Practice location

3500 S Western Ave
Oklahoma City, OK 73109-2413

Phone 405-632-5565 · Fax 405-632-3538

Mailing address

3500 S Western Ave
Oklahoma City, OK 73109-2413

Phone 405-632-5565 · Fax 405-632-3538

Authorized official

Craig Leon Abbott
Physician
4056325565

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