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General NPI Number Information
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NPI Number | 1578961538
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Entity Type | Organization
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Legal Business Name | LAURA JANE HOLSEY, D.O., P.C.
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 3543 WEST MEMORIAL ROAD HOLSEY COSMETIC SURGERY & SPA
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134
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Country | US
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Telephone | 405-256-2526
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Fax | 888-241-5833
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Provider Business Mailing Address
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Address Line | 10809 NW 36TH TERRACE
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City | YUKON
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State | OK
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Zip | 73099
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Country | US
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Telephone | 405-256-2526
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Fax | 888-241-5833
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA JANE HOLSEY
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Credential | D.O.
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Telephone | 405-620-6049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5397
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License Number State | OK
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