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General NPI Number Information
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NPI Number | 1376572909
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Entity Type | Individual
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Provider Name | LORA JOYCE LARSON MD
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 1705 E 19TH ST SUITE 600
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City | TULSA
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State | OK
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Zip | 74104-5405
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Country | US
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Telephone | 918-742-8847
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Fax | 918-877-1285
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Provider Business Mailing Address
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Address Line | 6600 S YALE AVE STE 1200
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City | TULSA
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State | OK
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Zip | 74136-3361
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Country | US
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Telephone | 918-488-6687
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Fax | 918-488-6098
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 13779
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License Number State | OK
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