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Individual

LAURIE LINN HAMILTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1334 N LANSING AVE, TULSA, OK 74106-5907
(918) 587-2171
Mailing address
1334 N LANSING AVE, TULSA, OK 74106-5907
(918) 587-2171

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
20A8886
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
3891
OK
207V00000X
Obstetrics & Gynecology Physician
DO25177
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100211740A
OK
01
1407812365
MEDICARE GROUP NPI NUMBER
OR
01
371803
GROUP MEDICARE PTAN
OK
01
CB3544
TRAV RR GROUP NUMBER
OR
01
P00412787
TRAV RR PTAN NUMBER
OR
01
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
11/18/2005
Last updated
01/10/2018
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