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Individual

DR. MAXIMO LEBUMFACIL FERNAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
350 S 40TH ST, MUSKOGEE, OK 74401-4915
(918) 683-0753
(866) 397-7556
Mailing address
350 S 40TH ST, MUSKOGEE, OK 74401-4915
(918) 683-0753
(866) 397-7556

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
19702
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100260010A
OK
Enumeration date
05/19/2006
Last updated
07/24/2015
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