Provider Demographics
NPI:1881723872
Name:LESTER, JEFFRY S (MD)
Entity type:Individual
Prefix:
First Name:JEFFRY
Middle Name:S
Last Name:LESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E SHURDEN INDUSTRIAL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437-7323
Mailing Address - Country:US
Mailing Address - Phone:580-225-2513
Mailing Address - Fax:580-303-5863
Practice Address - Street 1:104 E SHURDEN INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437-7323
Practice Address - Country:US
Practice Address - Phone:918-652-9614
Practice Address - Fax:918-652-4831
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK108002083X0100X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D34935Medicare UPIN