Lester Keathley
Nurse Practitioner - Family Medicine
700 N Main St
Gore
, Oklahoma 74435-2013
Lester Keathley
Nurse Practitioner - Family Medicine
700 N Main St
Gore
, Oklahoma 74435-2013
(918) 571-2369
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Lester Keathley
- 109 8th Street
- Gore, OK
- Zip : 74435
- Phone : (918) 571-2369
Second Address
- Lester Keathley
- 700 N Main St
- Gore, OK
- Zip : 74435-2013
- Phone : (918) 571-2369
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 103738 | OK |
National Provider Identifier
| NPI | 1003188962 |
|---|---|
| Provider Name | Lester Keathley |
| First Address | Gore, OK 74435 |
| Second Address | Gore, OK 74435-2013 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/02/2012 |
| Last Update Date | 18/08/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.