Individual
MS. MILDRED B LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3606 N CINCINNATI AVE, L.L.C., TULSA, OK 74106-1536
(918) 428-5373
(918) 428-8235
Mailing address
3606 N CINCINNATI AVE, L.L.C., TULSA, OK 74106-1536
(918) 428-5373
(918) 428-8235
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085002908
IL
363A00000X
Physician Assistant
Primary
1751
OK
Other
Enumeration date
06/04/2007
Last updated
08/12/2008
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