Provider Demographics
NPI:1083654800
Name:ARROWSMITH, LAURA LEE (DO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:ARROWSMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:ARROWSMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:4500 S GARNETT RD
Mailing Address - Street 2:STE 300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5229
Mailing Address - Country:US
Mailing Address - Phone:918-664-9892
Mailing Address - Fax:918-664-2521
Practice Address - Street 1:744 W 9TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9020
Practice Address - Country:US
Practice Address - Phone:918-664-9892
Practice Address - Fax:918-664-2521
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18412085R0202X
KS05-239072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100193370AMedicaid
KS100233940AMedicaid
OK100193370AMedicaid
KSP00415212Medicare PIN
KS100233940AMedicaid