Individual
LEONARD UDEL LACEFIELD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
717 S HOUSTON AVE STE 310, TULSA, OK 74127-9023
(918) 382-5064
(918) 382-3589
Mailing address
717 S HOUSTON AVE STE 310, TULSA, OK 74127-9023
(918) 382-5064
(918) 382-3589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.012139
OH
207R00000X
Internal Medicine Physician
Primary
5651
OK
207R00000X
Internal Medicine Physician
DO177881
OR
207R00000X
Internal Medicine Physician
OP60641490
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200542440A
—
OK
Enumeration date
02/19/2013
Last updated
02/14/2019
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