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1700957990
JEFFREY LANE BLACK
TULSA, OK
NPI
1700957990
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207PE0004X Emergency Medicine, Emergency Medical Services
(Licence: OK 16468)
Enumeration Date
2006-11-11
Last Update Date
2010-04-13
Business Address
-- JEFFREY LANE BLACK
1717 S UTICA AVE STE A
TULSA, OK 74104-5346
Phone number: 918-748-7557
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Mailing Address
-- JEFFREY LANE BLACK
1515 N HARVARD AVE STE E
TULSA, OK 74115-4957
Phone number: 918-832-6049
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