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NPI Code Detail

MEDICARE: LEE ALICE GOSCIN M.D., PH.D.

MEDICARE: LEE ALICE GOSCIN M.D., PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician29464OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154391084
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE ALICE GOSCIN M.D., PH.D.
Provider Business Mailing Address
First Line : 101 OKLAHOMA AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7520
Country : US
Telephone Number : 918-423-4900
Fax Number : 918-423-4907
Provider Business Practice Location Address
First Line : 101 OKLAHOMA AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7520
Country : US
Telephone Number : 918-423-4900
Fax Number : 918-423-4907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 02/04/2015

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