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NPI Code Detail

MEDICARE: MS. LAURA K SOPER P.A.

MEDICARE:  MS. LAURA K SOPER  P.A.
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
1207Q00000XFamily Medicine Physician348OK
2208000000XPediatrics Physician348OK

General Provider Information

NPI Number : 1558308601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAURA K SOPER P.A.
Provider Business Mailing Address
First Line : 430 N MONTE VISTA ST
Second Line :
City : ADA
State : OK
Zip : 74820-4610
Country : US
Telephone Number : 580-310-9510
Fax Number : 580-436-4447
Provider Business Practice Location Address
First Line : 430 N MONTE VISTA ST
Second Line :
City : ADA
State : OK
Zip : 74820-4610
Country : US
Telephone Number : 580-310-9510
Fax Number : 580-436-4447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/11/2025

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Directions to “ MS. LAURA K SOPER P.A.” Practice Location

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