Healthcare Provider Details

I. General information

NPI: 1942321971
Provider Name (Legal Business Name): LORI L. WHITMAN HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 S WESTERN AVE
OKLAHOMA CITY OK
73139-2002
US

IV. Provider business mailing address

216 CASTLE ROCK RD
YUKON OK
73099-4425
US

V. Phone/Fax

Practice location:
  • Phone: 405-632-3862
  • Fax: 405-632-7436
Mailing address:
  • Phone: 405-354-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number931
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: