Healthcare Provider Details

I. General information

NPI: 1164914966
Provider Name (Legal Business Name): LISA MARIE SETTLE DO, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

1200 CHILDREN'S AVE OUCP 14000
OKLAHOMA CITY OK
73104
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4417
  • Fax:
Mailing address:
  • Phone: 405-271-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberV0158
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: