Healthcare Provider Details

I. General information

NPI: 1902833692
Provider Name (Legal Business Name): LORI FLETCHER STEELE P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 E 41ST ST 3RD FLOOR, STE A
TULSA OK
74135-2527
US

IV. Provider business mailing address

PO BOX 268838
OKLAHOMA CITY OK
73126-8838
US

V. Phone/Fax

Practice location:
  • Phone: 918-619-4400
  • Fax: 918-619-4152
Mailing address:
  • Phone: 918-619-4400
  • Fax: 918-660-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number492
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: