Provider Demographics
NPI:1457742959
Name:LEE PLETTS GOSCIN MD PHD PA
Entity Type:Organization
Organization Name:LEE PLETTS GOSCIN MD PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSCIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-798-4649
Mailing Address - Street 1:101 OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7520
Mailing Address - Country:US
Mailing Address - Phone:918-423-4900
Mailing Address - Fax:918-423-4907
Practice Address - Street 1:101 OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-7520
Practice Address - Country:US
Practice Address - Phone:918-423-4900
Practice Address - Fax:918-423-4907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29464207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty