Provider Demographics
NPI:1679067664
Name:ALFREY, LAURIE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ANN
Last Name:ALFREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-7406
Mailing Address - Country:US
Mailing Address - Phone:918-269-8874
Mailing Address - Fax:
Practice Address - Street 1:1025 E 18TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-7406
Practice Address - Country:US
Practice Address - Phone:918-269-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19891208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics