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Individual

DR. VINICIUS MACHADO JORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
104 NW 31ST ST, LAWTON, OK 73505-6100
(580) 536-2121
Mailing address
104 NW 31ST ST, LAWTON, OK 73505-6100
(580) 536-2121

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT209656
PA
207RH0003X
Hematology & Oncology Physician
Primary
37383
OK

Other

Enumeration date
06/22/2015
Last updated
08/02/2021
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