Individual
DR. RENAE LYNE MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8803 S 101ST EAST AVE, STE 130, TULSA, OK 74133-5726
(918) 579-3850
(918) 294-6929
Mailing address
8803 S 101ST EAST AVE, STE 130, TULSA, OK 74133-5726
(918) 579-3850
(918) 294-6929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22105
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100186290A
—
OK
Enumeration date
06/01/2006
Last updated
07/30/2014
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