Individual
DR. LAURIE ANN MCLEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
716 S HIGHWAY 77, NEWKIRK, OK 74647-7009
(580) 362-2555
(580) 362-2948
Mailing address
212 N MAIN ST, FAIRFAX, OK 74637-3023
(918) 642-3100
(918) 642-5639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20143
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100192280A
—
OK
05
—
100768880I
—
OK
05
—
100768880J
—
OK
01
—
OK402465
MEDICARE PTAN
OK
Enumeration date
01/24/2007
Last updated
12/28/2017
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