Healthcare Provider Details

I. General information

NPI: 1760912380
Provider Name (Legal Business Name): LINDA LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 S. YALE AVE. 215
TULSA OK
74136
US

IV. Provider business mailing address

7010 S YALE AVE STE 215
TULSA OK
74136-5743
US

V. Phone/Fax

Practice location:
  • Phone: 918-492-2554
  • Fax:
Mailing address:
  • Phone: 918-492-2554
  • 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: