Provider Demographics
NPI:1528052875
Name:STEELBERG, SCHUYLER TACKETT (MD)
Entity type:Individual
Prefix:DR
First Name:SCHUYLER
Middle Name:TACKETT
Last Name:STEELBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19924 E WILDERNESS RD
Mailing Address - Street 2:
Mailing Address - City:COOKSON
Mailing Address - State:OK
Mailing Address - Zip Code:74427-2461
Mailing Address - Country:US
Mailing Address - Phone:918-453-5256
Mailing Address - Fax:918-458-6124
Practice Address - Street 1:19924 E WILDERNESS RD
Practice Address - Street 2:
Practice Address - City:COOKSON
Practice Address - State:OK
Practice Address - Zip Code:74427-2461
Practice Address - Country:US
Practice Address - Phone:918-453-5256
Practice Address - Fax:918-458-6124
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine