Individual
DR. LANCE L. LEDBETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
232 W MAIN ST, MOORE, OK 73160-5142
(405) 794-3588
(405) 794-0306
Mailing address
232 W MAIN ST, MOORE, OK 73160-5142
(405) 794-3588
(405) 794-0306
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1180
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1320340001
PALMETTO SUPPLIER ID
OK
Enumeration date
08/17/2005
Last updated
06/21/2022
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