Provider Demographics
NPI:1831714658
Name:R&R DERMATOLOGY SERVICES PLLC
Entity type:Organization
Organization Name:R&R DERMATOLOGY SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-803-8020
Mailing Address - Street 1:PO BOX 54333
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73154-1333
Mailing Address - Country:US
Mailing Address - Phone:405-803-8020
Mailing Address - Fax:405-437-2332
Practice Address - Street 1:13301 N MERIDIAN AVE STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8381
Practice Address - Country:US
Practice Address - Phone:405-803-8020
Practice Address - Fax:405-437-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty