Provider Demographics
NPI:1740341577
Name:LAHR, STEVAN EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:STEVAN
Middle Name:EDWARD
Last Name:LAHR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:650 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-4429
Mailing Address - Country:US
Mailing Address - Phone:918-587-9471
Mailing Address - Fax:918-560-1399
Practice Address - Street 1:2325 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-712-4301
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK43082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200073430AMedicaid
OKOK400984Medicare PIN