Provider Demographics
NPI:1922092873
Name:HIGHTOWER, LANCE W (DC)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:W
Last Name:HIGHTOWER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6048 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-9212
Mailing Address - Country:US
Mailing Address - Phone:918-828-9011
Mailing Address - Fax:918-392-7602
Practice Address - Street 1:6048 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9212
Practice Address - Country:US
Practice Address - Phone:918-828-9011
Practice Address - Fax:918-392-7602
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3407111N00000X
OK489111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66910Medicare UPIN