Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 19839 | OK |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 19839 | OK |
NPI | 1043211980 |
---|---|
Provider Name | Jay D Lorton |
First Address | Tulsa, OK 74137-4265 |
Second Address | Tulsa, OK 74137-4265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 02/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100125390A | (05) | OK |
H26333 | (02) | OK |