Provider Demographics
NPI:1609823285
Name:LESTER, MITCHELL N (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:N
Last Name:LESTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1501 N FLORENCE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3189
Mailing Address - Country:US
Mailing Address - Phone:918-341-1886
Mailing Address - Fax:918-341-5164
Practice Address - Street 1:7912 E 31ST CT
Practice Address - Street 2:STE. 210
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1315
Practice Address - Country:US
Practice Address - Phone:918-392-4456
Practice Address - Fax:918-392-4465
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2011-08-29
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Provider Licenses
StateLicense IDTaxonomies
OK18592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG20877Medicare UPIN