Healthcare Provider Details

I. General information

NPI: 1841551934
Provider Name (Legal Business Name): LEE MARVIN E RAMOS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10507 E 91ST ST SUITE 250
TULSA OK
74133-5589
US

IV. Provider business mailing address

6600 S YALE AVE SUITE 1400
TULSA OK
74136-3347
US

V. Phone/Fax

Practice location:
  • Phone: 918-307-5560
  • Fax:
Mailing address:
  • Phone: 918-488-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5427
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: