Provider Demographics
NPI:1598995649
Name:LASHLEY, NATHAN JAMES (DPM)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JAMES
Last Name:LASHLEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:NATE
Other - Middle Name:
Other - Last Name:LASHLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:701 W. ELGIN ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012
Mailing Address - Country:US
Mailing Address - Phone:918-455-2001
Mailing Address - Fax:918-301-0088
Practice Address - Street 1:3627 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135
Practice Address - Country:US
Practice Address - Phone:918-747-4855
Practice Address - Fax:918-747-4866
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK266213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100685820CMedicaid
OK1598995649OtherNPI