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Individual

MRS. LESLEY VAUGHN LANDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2005 E 21ST ST STE 350, TULSA, OK 74114-1403
(918) 764-8516
(918) 764-8514
Mailing address
2005 E 21ST ST STE 350, TULSA, OK 74114-1403
(918) 764-8516
(918) 764-8514

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
25842
OK
208600000X
Surgery Physician
25842
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200173290A
OK
Enumeration date
06/28/2007
Last updated
08/22/2023
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