Individual
DR. LISA MASK BULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9245 S MINGO RD, TULSA, OK 74133
(918) 492-8980
(918) 495-0607
Mailing address
9245 S MINGO RD, TULSA, OK 74133-5793
(918) 492-8980
(918) 495-0607
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
30038
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2013
Last updated
09/24/2019
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