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NPI Code Detail

MEDICARE: STEPHANIE ELISE LETNEY D.O.

MEDICARE: STEPHANIE ELISE LETNEY D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician6016OK
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1114311354
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ELISE LETNEY D.O.
Provider Business Mailing Address
First Line : 1400 W PAWNEE ST
Second Line :
City : CLEVELAND
State : OK
Zip : 74020-3020
Country : US
Telephone Number : 918-358-3588
Fax Number : 918-358-2639
Provider Business Practice Location Address
First Line : 1400 W PAWNEE ST
Second Line :
City : CLEVELAND
State : OK
Zip : 74020-3020
Country : US
Telephone Number : 918-358-3588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2015
Last Update Date : 12/04/2020

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Directions to “ STEPHANIE ELISE LETNEY D.O.” Practice Location

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