Healthcare Provider Details

I. General information

NPI: 1740044791
Provider Name (Legal Business Name): OREON O LEBLANC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S HARVARD AVE
TULSA OK
74114-3300
US

IV. Provider business mailing address

305 N 53RD WEST AVE
TULSA OK
74127-6222
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-4301
  • Fax:
Mailing address:
  • Phone: 918-933-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: