Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southside Dermatology PLLC

Organization Dermatology Physician · NPI 1073263380

Southside Dermatology PLLC is a Dermatology Physician in Broken Arrow, Oklahoma. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3300 S Aspen Ave Ste A
Broken Arrow, OK 74012-7501
Phone: (918) 760-0700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1073263380
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alison Fischer — Owner · (918) 760-0700
NPI enumeratedMarch 28, 2022
Last updated in NPPESMarch 28, 2022
Certification dateMarch 28, 2022
Mailing address6966 S Utica Ave Ste 225, Tulsa, OK 74136-3903

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