Female

Laurie C. Clark DO

Family Medicine Physician in Tulsa, OK(View on Map)

Full Name

Laurie C Clark DO

NPI Number

1801864178

NPI Type

Individual Provider

Gender

Female

Enumeration Date

03/10/2006

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

California
Illinois
Oklahoma

License Number

20A10664
036130673
2356

Contact
Information

Purpose

Mailing
Location

Address

14002 E 21ST ST STE 1130
14002 E 21ST ST STE 1130

City

Tulsa
Tulsa

State

OK
OK

Postal Code

74134-1408
74134-1408

Country

US
US

Telephone Number

(918) 439-1500
(918) 439-1500

Identifiers

Identifier

100136290C

Identifier State

OK

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/13/2019

Provider Address

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