Individual
LOIS I JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6112 E 61ST STREET, TULSA, OK 74136
(918) 492-6432
(918) 491-1613
Mailing address
6112 E 61ST STREET, TULSA, OK 74136
(918) 492-6432
(918) 491-1613
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4184
OK
Other
Enumeration date
09/19/2006
Last updated
07/08/2007
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