Individual
DR. LENNY D STUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4050 W MEMORIAL RD FL 3, OKLAHOMA CITY, OK 73120-8382
(405) 608-3800
(405) 608-4768
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
21272
OK
2086S0129X
Vascular Surgery Physician
Primary
21272
OK
2086S0129X
Vascular Surgery Physician
21272
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200028610A
—
OK
01
—
P00219549
RAILROAD MEDICARE
OK
Enumeration date
10/05/2005
Last updated
06/06/2022
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