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Individual

LISA JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
402 4TH AVE SW, ARDMORE, OK 73401-4935
(580) 798-4523
Mailing address
402 4TH AVE SW, ARDMORE, OK 73401-4935
(405) 201-1267

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M081019050
DRIVERS LICENSE
OK
Enumeration date
04/03/2018
Last updated
04/03/2018
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Product
  • Claims
  • Eligibility checks
  • EDI platform