Provider Demographics
NPI:1578961538
Name:LAURA JANE HOLSEY, D.O., P.C.
Entity Type:Organization
Organization Name:LAURA JANE HOLSEY, D.O., P.C.
Other - Org Name:HOLSEY COSMETIC SURGERY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HOLSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-620-6049
Mailing Address - Street 1:10809 NW 36TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099
Mailing Address - Country:US
Mailing Address - Phone:405-256-2526
Mailing Address - Fax:888-241-5833
Practice Address - Street 1:3543 WEST MEMORIAL ROAD
Practice Address - Street 2:HOLSEY COSMETIC SURGERY & SPA
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134
Practice Address - Country:US
Practice Address - Phone:405-256-2526
Practice Address - Fax:888-241-5833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5397208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty