Provider Demographics
NPI:1912907023
Name:TATE, STEVEN A (PA)
Entity type:Individual
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First Name:STEVEN
Middle Name:A
Last Name:TATE
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Gender:M
Credentials:PA
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Mailing Address - Street 1:2210 DUNCAN REGIONAL LOOP
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1564
Mailing Address - Country:US
Mailing Address - Phone:580-252-6080
Mailing Address - Fax:580-255-1064
Practice Address - Street 1:1307 JACKIE RD
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1566
Practice Address - Country:US
Practice Address - Phone:580-255-6100
Practice Address - Fax:580-255-6102
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2018-10-17
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Provider Licenses
StateLicense IDTaxonomies
OK1184363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP64502Medicare UPIN