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Individual

JOHN C LEATHERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 WYANDOTTE PL, RAMONA, OK 74061-3678
(918) 287-1310
(918) 287-1727
Mailing address
PO BOX 420, RAMONA, OK 74061-0420
(918) 536-1024
(918) 536-2203

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17649
OK
207R00000X
Internal Medicine Physician
17649
OK

Other

Enumeration date
06/16/2006
Last updated
03/06/2020
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