Healthcare Provider Details

I. General information

NPI: 1508854308
Provider Name (Legal Business Name): STEPHEN THOMAS LESTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 S YALE AVE STE 1110
TULSA OK
74136-8384
US

IV. Provider business mailing address

4807 E 91ST ST LB003
TULSA OK
74137-2841
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-7246
  • Fax: 918-502-7250
Mailing address:
  • Phone: 918-502-7246
  • Fax: 918-502-7250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number16519
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: