# DR. JOHN C. LEATHERMAN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033742283
- **Authorized official:** JOHN C LEATHERMAN MD (CEO)
- **Authorized official phone:** (918) 876-2238

## Contact information

- **Practice address:** 400 WYANDOTTE PL, RAMONA, OK 74061-3678
- **Practice address phone:** (918) 536-1024
- **Practice address fax:** (918) 536-4003
- **Mailing address:** PO BOX 420, RAMONA, OK 74061-0420
- **Mailing address phone:** (918) 536-1024
- **Mailing address fax:** (918) 536-4003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2020
- **Last updated:** 02/17/2020