Provider Demographics
NPI:1871553107
Name:MAGNESS, STEVEN M (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:MAGNESS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-936-5211
Practice Address - Street 1:4140 W MEMORIAL RD
Practice Address - Street 2:STE 621
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8366
Practice Address - Country:US
Practice Address - Phone:405-749-4231
Practice Address - Fax:405-749-4234
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-05-20
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Provider Licenses
StateLicense IDTaxonomies
OK20257208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100138150CMedicaid
OK100138150CMedicaid
OK248510808Medicare PIN
OKP00221951Medicare PIN