Individual
DR. JAY E LEEMASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2909 S TELEPHONE RD, MOORE, OK 73160-2937
(405) 799-7510
(405) 799-4742
Mailing address
2909 S TELEPHONE RD, MOORE, OK 73160-2937
(405) 799-7510
(405) 799-4742
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13242
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123420A
—
OK
01
—
731434343
TAX ID#
OK
01
—
731434343001
BXBS
OK
Enumeration date
06/15/2005
Last updated
02/03/2010
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