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STILLWATER SKIN & CANCER MEDICAL CLINIC, INC
NPI 1790839900
Specialist in Stillwater, OK

Active since January 23, 2007
1604 W 8TH AVE, STILLWATER, OK 74074(405) 624-1077(405) 377-2273 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Aug 7, 2017 (3 updates tracked since 2017).

About Stillwater Skin & Cancer Medical Clinic, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STILLWATER SKIN & CANCER MEDICAL CLINIC, INC (NPI 1790839900) is a healthcare organization registered as a specialist in Stillwater, Oklahoma and active in the NPI registry since January 2007. The organization maintains a secondary practice location in Ponca City and lists Robert A Breedlove, Owner, as its authorized official.

NPPES Registry Identity

NPI1790839900
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSTILLWATER SKIN & CANCER MEDICAL CLINIC, INC
Location Address1604 W 8TH AVEStillwater, OK 74074-4207
Mailing AddressPo Box 108809Oklahoma City, OK 73101-8809 · (405) 624-1077 · Fax (405) 377-2273
Phone(405) 624-1077
Fax(405) 377-2273
Organization SubpartNo
Authorized OfficialRobert A BreedloveOwner · (405) 624-1077
Enumeration DateJanuary 23, 2007
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1790839900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in OK · 10612
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1604 W 8TH AVE, Stillwater, OK 74074
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Secondary Practice Location 1

Location 11722 N 4th StPonca City, OK 74601-2745 · Phone (405) 624-1077 · Fax (405) 377-2273

Other Identifiers 2

Other1588609606OK · Npi
Other1790839900OK · Group Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT ALLAN BREEDLOVE M.D., FAAD
Dermatology
1604 W 8TH AVE
STILLWATER, OK 74074
Payne County (405) 624-1077

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stillwater Skin & Cancer Medical Clinic, Inc's NPI number?

The NPI number for Stillwater Skin & Cancer Medical Clinic, Inc is 1790839900. It was assigned to this organization in the NPPES registry on January 23, 2007.

Where is Stillwater Skin & Cancer Medical Clinic, Inc located?

Stillwater Skin & Cancer Medical Clinic, Inc is located at 1604 W 8th Ave, Stillwater, OK 74074. The listed phone number is (405) 624-1077.

What is Stillwater Skin & Cancer Medical Clinic, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Stillwater Skin & Cancer Medical Clinic, Inc was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.