Individual
CAROL A LENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
102 NW 31ST, LAWTON, OK 73505
(580) 353-6790
(580) 510-7019
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
22213
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048624860001
BCBS -102 NW 31ST STREET
OK
05
—
100004490A
—
OK
01
—
160053318
RAILROAD MEDICARE
—
01
—
7901279
AETNA
OK
Enumeration date
09/19/2005
Last updated
11/01/2012
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