JACK T DANCER I (NPI# 1235212630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235212630 |
| Entity Type | Individual |
| Full Name | JACK T DANCER I |
| Credential | M.D. |
| Practice Address |
1301 W 6th Ave Suite 105 Stillwater OK 74074-4375 |
| Practice Telephone | 4055331074 |
| Mailing Telephone | 4055331074 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 7845 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1301 W 6TH AVE SUITE 105 |
| City | STILLWATER |
| State | OK |
| Zip Code | 74074-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972596641 | Alison Faith Dancer | Psychiatry & Neurology | 1301 W 6th Ave, Suite 210, Stillwater, OK 74074-4381 | 2005-08-26 |
| 1932655966 | Caitlin Kronenwetter | Physician Assistant | 1301 W 6th Ave, Ste 207, Stillwater, OK 74074-4375 | 2016-08-30 |
| 1619337433 | Erin Hutchison | Physician Assistant | 1301 W 6th Ave, Ste 207, Stillwater, OK 74074-4375 | 2016-03-07 |
| 1669770145 | Jawad Trad | Internal Medicine | 1301 W 6th Ave, Suite 208, Stillwater, OK 74074-4375 | 2011-03-07 |
| 1811171705 | Shyam Sunder Poludasu | Internal Medicine | 1301 W 6th Ave, Ste 207, Stillwater, OK 74074-4375 | 2007-12-27 |
| 1699866616 | Stillwater Heart Center Inc | Specialist | 1301 W 6th Ave, Suite 110, Stillwater, OK 74074-4375 | 2006-09-27 |
| 1679588552 | Stillwater Medical Center Authority | Psychiatry & Neurology | 1301 W 6th Ave, Suite 108, Stillwater, OK 74074-4375 | 2006-07-30 |
| 1194708545 | James A. Waltermire | Radiology | 1301 W 6th Ave, Suite 202, Stillwater, OK 74074-4375 | 2005-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090680 | Jason K. White, Ph.d., LLC | Psychologist | 807 S. Pine St., Stillwater, OK 74074 | 2019-08-29 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1881256691 | Shelly Lynn Green | Nurse Practitioner | 1321 W. 7th Street, Stillwater, OK 74074 | 2019-07-01 |
| 1811426273 | Judy Catlett | Case Manager/Care Coordinator | 800 E. 6th Str, Stillwater, OK 74074 | 2017-06-08 |
| 1518322296 | Abi Physical Therapy Services | Physical Therapist | 810 S. Walnut Street, Stillwater, OK 74074 | 2015-12-22 |
| 1366833451 | Connecting The Pieces | Case Management | 812 S Walnut, Stillwater, OK 74074 | 2015-02-10 |
| 1790122414 | Airie Flanagan | Doula | 2601 Gregory Ln, Stillwater, OK 74074 | 2013-06-04 |
| 1760720668 | Stillwater Histology LLC | Internal Medicine | 1301 W. 6th St, Suite 106, Stillwater, OK 74074 | 2013-01-28 |
| 1144570565 | Nikkie Jo Dunnigan | Counselor | 2322 W 7th, Stillwater, OK 74074 | 2012-09-13 |
| 1487889952 | Lynn B. Roberts | General Practice | 1321 W 7th St, Stillwater Community Health, Stillwater, OK 74074 | 2009-05-27 |
| Find all providers in zip 74074 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467502138 | Cara Denise Pence | Surgery | 1301 W 6th Ave Ste 105, Stillwater, OK 74074-4376 | 2007-01-12 |
| 1346507415 | Timothy M Perkins | Surgery | 1500 Curve Crest Blvd W, Stillwater, MN 55082 | 2012-04-13 |
| 1063642965 | Mark E George | Surgery | 1500 Curve Crest Boulevard, Stillwater Medical Group, Stillwater, MN 55082-6040 | 2009-07-26 |
| 1114105376 | Eric James Saterbak | Surgery | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2008-02-08 |
| 1255524989 | Cimarron Ambulatory Services, LLC | Surgery | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2007-08-27 |
| 1326245804 | Jerrod Lee Vaughn | Surgery | 1301 W 6th Ave Ste 105, Stillwater Surgical Associates, Stillwater, OK 74074-4376 | 2007-06-28 |
| 1962573022 | Amy Catherine Fox | Surgery | 1500 Curve Crest Blvd W, Stillwater Medical Group/regions Healthpartners, Stillwater, MN 55082 | 2006-11-12 |
| 1538144365 | Kevin John Bjork | Surgery | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2005-12-14 |
| 1477537272 | Elmer Harold Kasperson | Surgery | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702127 | Advanced Surgical Assisting, LLC | Surgery | 4012 E 108th St, Tulsa, OK 74137-6707 | 2020-05-20 |
| 1639642655 | Okc Surgicalists Pllc | Surgery | 4140 W Memorial Rd Ste 408, Oklahoma City, OK 73120-8300 | 2019-01-03 |
| 1376016329 | Oklahoma Acute Care Surgical Specialists LLC | Surgery | 4016 E 27th St, Tulsa, OK 74114-5908 | 2019-01-02 |
| 1265907885 | Apex Surgery Center, LLC | Surgery | 2001 Cradduck Road, Ada, OK 74820 | 2018-10-10 |
| 1588107957 | Elias Cardiovascular Disease Pllc | Surgery | 1104 E State Highway 152 Unit 2, Mustang, OK 73064-5116 | 2016-12-02 |
| 1831540608 | Eric Waetjen | Surgery | 4502 E 51st St, 2g06, Tulsa, OK 74135-3702 | 2016-06-23 |
| 1811381247 | Mohamad Sidani | Surgery | 800 Stanton L Young Blvd # 9432, Oklahoma City, OK 73104-5018 | 2015-03-24 |
| 1336554880 | Alex Jones | Surgery | 500 E Robinson St Ste 1300, Norman, OK 73071-6694 | 2014-06-24 |
| 1396159596 | Paul Mcgaha II | Surgery | 10920 Sw 30th Ter, Yukon, OK 73099-0435 | 2014-06-16 |
| 1154747053 | Haley Adams | Surgery | 115 W 13th St, Grove, OK 74344-3224 | 2014-03-15 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 74074 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.