Individual
DR. LISA E HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
715 W MAIN ST STE S, JENKS, OK 74037-3553
(918) 745-0501
(918) 747-9778
Mailing address
715 W MAIN ST STE S, JENKS, OK 74037-3553
(918) 745-0501
(918) 747-9778
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4161
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200182250B
—
OK
Enumeration date
12/01/2005
Last updated
01/09/2020
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