Individual
MARK C LEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1414 ARLINGTON ST, SUITE 2300, ADA, OK 74820-2643
(580) 332-0112
(580) 332-1005
Mailing address
1414 ARLINGTON ST, SUITE 2300, ADA, OK 74820-2643
(580) 332-0112
(580) 332-1005
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00722
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100131200A
—
OK
Enumeration date
09/13/2005
Last updated
08/11/2010
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