Southmayd, Leroy
Southmayd, Leroy is an individual health care provider with primary practice located at 1202 W Wilshire Blvd , Oklahoma City OK 73116-6109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Southmayd, Leroy can be contacted via phone (405) 823-3073.Contact Information
Primary practice address
1202 W Wilshire Blvd
Oklahoma City OK 73116-6109
Phone: (405) 823-3073
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 17164 | Oklahoma |
Profile Details
| NPI number | 1851351969 |
|---|---|
| LBN Legal business name | Southmayd, Leroy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Mar 8th, 2020 - 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 | 1851351969 | NPPES |
| Oklahoma | MEDICAID | 100219420B |
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