Provider Demographics
NPI:1699969873
Name:DOLBOW, ELISHA RANNELL (CFA)
Entity type:Individual
Prefix:MRS
First Name:ELISHA
Middle Name:RANNELL
Last Name:DOLBOW
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8803 S 101ST EAST AVE STE 383
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5732
Mailing Address - Country:US
Mailing Address - Phone:918-392-5696
Mailing Address - Fax:918-392-5697
Practice Address - Street 1:8803 S 101ST EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5726
Practice Address - Country:US
Practice Address - Phone:918-392-5696
Practice Address - Fax:918-392-5697
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK88620246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist