Individual
CONNIE JO LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4111 S DARLINGTON AVE, #425, TULSA, OK 74135
(918) 742-2069
(918) 712-9883
Mailing address
4111 S DARLINGTON AVE, #425, TULSA, OK 74135
(918) 742-2069
(918) 712-9883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14769
OK
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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