Provider Demographics
NPI:1215113790
Name:E ALEXANDER L'HEUREUX JR MD PC
Entity type:Organization
Organization Name:E ALEXANDER L'HEUREUX JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:L'HEUREUX
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:405-844-5222
Mailing Address - Street 1:1405 NW 150TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1305
Mailing Address - Country:US
Mailing Address - Phone:405-844-5222
Mailing Address - Fax:405-844-2166
Practice Address - Street 1:1405 NW 150TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1305
Practice Address - Country:US
Practice Address - Phone:405-844-5222
Practice Address - Fax:405-844-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20354174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG32754Medicare UPIN