Bethel Mulligan, Lesa Jean
Bethel Mulligan, Lesa Jean is an individual health care provider with primary practice located at 1139 36Th Ave Nw , Norman OK 73072-4103. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Bethel Mulligan, Lesa Jean can be contacted via phone (405) 364-0643.Contact Information
Primary practice address
1139 36Th Ave Nw
Norman OK 73072-4103
Phone: (405) 364-0643
Fax: (405) 364-0502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 18183 | Oklahoma |
Profile Details
| NPI number | 1255395984 |
|---|---|
| LBN Legal business name | Bethel Mulligan, Lesa Jean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2006 |
| Last updated | Oct 14th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255395984 | NPPES |
| Oklahoma | Other | 100131240B | SOONERCARE |
| Oklahoma | MEDICAID | 100131240A | SOONERCARE |
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