Individual
LISA B. CONNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1016 24TH AVE NW STE 110, NORMAN, OK 73069-6542
(405) 701-4079
(405) 701-8988
Mailing address
1016 24TH AVE NW STE 110, NORMAN, OK 73069-6542
(405) 701-4079
(405) 701-8988
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16929
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080058651
RAILROAD MEDICARE
OK
05
—
100113800A
—
OK
01
—
4206638
AETNA EDI
OK
Enumeration date
08/18/2005
Last updated
03/17/2025
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