Provider Demographics
NPI:1508854308
Name:LESTER, STEPHEN THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:THOMAS
Last Name:LESTER
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 1:4807 E 91ST ST
Mailing Address - Street 2:LB003
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2841
Mailing Address - Country:US
Mailing Address - Phone:918-502-7246
Mailing Address - Fax:918-502-7250
Practice Address - Street 1:6585 S YALE AVE
Practice Address - Street 2:STE 1110
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8384
Practice Address - Country:US
Practice Address - Phone:918-502-7246
Practice Address - Fax:918-502-7250
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16519208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK680535868002OtherBLUE CROSS BLUE SHIELD
OK200070240AMedicaid
OKDA8285OtherMEDICARE RAILROAD
5830046OtherAETNA
OKDA8285OtherMEDICARE RAILROAD
C71472Medicare UPIN