Provider Demographics
NPI:1255314811
Name:RAMSEYER, LORENZ T (MD)
Entity Type:Individual
Prefix:
First Name:LORENZ
Middle Name:T
Last Name:RAMSEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W MAINE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 S MONROE ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-7211
Practice Address - Country:US
Practice Address - Phone:580-234-2878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK173172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK300029203OtherRR MEDICARE
OK100211900AMedicaid
OK100211900AMedicaid
OKHOSPR108Medicare PIN