Individual
LISA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2502 WOODWARD BLVD, TULSA, OK 74114-2634
(918) 688-7602
Mailing address
2502 WOODWARD BLVD, TULSA, OK 74114-2634
(918) 688-7602
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2891
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100119720A
—
OK
05
—
100363130A
—
KS
05
—
133960003
—
AR
05
—
160478701
—
TX
05
—
206280703
—
MO
Enumeration date
06/23/2005
Last updated
12/11/2015
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