Organization
LUMINARY DERMATOLOGY OF OKLAHOMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA PHILLIPS (CEO)
(941) 302-4669
Entity
Organization
Contact information
Practice address
1218 E 9TH ST STE 1, EDMOND, OK 73034-5796
(405) 856-0020
(405) 856-0021
Mailing address
4411 BEE RIDGE RD, PMB 309, SARASOTA, FL 34233-2514
(405) 856-0020
(405) 856-0021
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
09/24/2021
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