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General NPI Number Information
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NPI Number | 1467438788
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Entity Type | Individual
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Provider Name | FLOYD J LASHLEY JR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 402 N BROADWAY
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City | WALTERS
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State | OK
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Zip | 73572
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Country | US
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Telephone | 580-875-3347
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Fax | 580-875-2978
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Provider Business Mailing Address
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Address Line | 402 N BROADWAY ST
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City | WALTERS
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State | OK
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Zip | 73572-1230
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Country | US
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Telephone | 580-875-6212
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Fax | 580-875-6221
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7637
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License Number State | OK
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