Provider Demographics
NPI:1780607952
Name:LUBIN, EDITH J (MD)
Entity type:Individual
Prefix:DR
First Name:EDITH
Middle Name:J
Last Name:LUBIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-2228
Mailing Address - Country:US
Mailing Address - Phone:888-803-3370
Mailing Address - Fax:
Practice Address - Street 1:100 NE 5TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-2228
Practice Address - Country:US
Practice Address - Phone:888-803-3070
Practice Address - Fax:888-803-3331
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200445240AMedicaid
OK200445240AMedicaid