Individual
DR. LISA DIANE MACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2950 S ELM PL, SUITE 160, BROKEN ARROW, OK 74012-7877
(918) 449-3750
(918) 449-3755
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001
(918) 488-6010
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28585
OK
Other
Enumeration date
05/01/2011
Last updated
07/30/2014
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