Stillwater Skin & Cancer Medical Clinic, Inc
NPI 1790839900 · Specialist · Stillwater, OK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Stillwater Skin & Cancer Medical Clinic, Inc is a Specialist organization in Stillwater, OK (NPI 1790839900).
Provider details
- NPI number
- 1790839900
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Robert Breedlove, Owner(405) 624-1077
- License
- 10612 (OK)
Specialties & taxonomies
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1722 N 4th StPonca City, OK 74601-2745Phone: (405) 624-1077Fax: (405) 377-2273
Registry dates
- Enumerated
- 2007-01-23
- Last updated
- 2022-07-21
Frequently asked questions
- What is Stillwater Skin & Cancer Medical Clinic, Inc's NPI number?
- Stillwater Skin & Cancer Medical Clinic, Inc's National Provider Identifier (NPI) is 1790839900, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Stillwater Skin & Cancer Medical Clinic, Inc?
- Stillwater Skin & Cancer Medical Clinic, Inc is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Stillwater Skin & Cancer Medical Clinic, Inc located?
- Stillwater Skin & Cancer Medical Clinic, Inc's practice location on file with NPPES is 1604 W 8th Ave, Stillwater, OK 74074-4207.
- What is Stillwater Skin & Cancer Medical Clinic, Inc's phone number?
- The practice phone number listed in the NPPES registry for Stillwater Skin & Cancer Medical Clinic, Inc is (405) 624-1077.
- Does Stillwater Skin & Cancer Medical Clinic, Inc accept Medicare?
- Stillwater Skin & Cancer Medical Clinic, Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Stillwater Skin & Cancer Medical Clinic, Inc?
- The authorized official listed on Stillwater Skin & Cancer Medical Clinic, Inc's NPPES record is Robert Breedlove, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Stillwater Skin & Cancer Medical Clinic, Inc's NPI active?
- Yes — Stillwater Skin & Cancer Medical Clinic, Inc's NPI (1790839900) is active in the NPPES registry as of the last update on 2022-07-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.