| Doctor Name: | MR. STEPHEN A FEUERBORN |
| NPI Number: | 1760441612 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 17432 |
| Business Practice Address: | 2249 Boren Blvd Seminole, OK - 748681927 |
| Business Phone Number: | 4053823650 |
| Business Fax Number: | 4053826028 |
| Mailing Address: | 2249 Boren Blvd, SEMINOLE |
| State: | OK |
| Postal Code: | 748681927 |
| Phone Number: | 4053823650 |
| Fax Number: | 4053826028 |
| NPI Enumeration Date: | 03/20/2006 |
| NPI Last Update Date: | 11/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17432 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |