Provider Demographics
NPI:1689762858
Name:LESLIE J. OLLAR-SHOEMAKE, D.O., P.C.
Entity Type:Organization
Organization Name:LESLIE J. OLLAR-SHOEMAKE, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLLAR-SHOEMAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-360-1264
Mailing Address - Street 1:500 E ROBINSON ST
Mailing Address - Street 2:STE 2400
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6697
Mailing Address - Country:US
Mailing Address - Phone:405-360-1264
Mailing Address - Fax:405-321-8683
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:STE 2400
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-360-1264
Practice Address - Fax:405-321-8683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty