Basic Information
| Provider Information | |||||||||
| NPI: | 1043359524 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOBB | ||||||||
| FirstName: | QUENTIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3650 W ROCK CREEK RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730722202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057013418 | ||||||||
| FaxNumber: | 4057013451 | ||||||||
| Practice Location | |||||||||
| Address1: | 3650 W ROCK CREEK RD | ||||||||
| Address2: | SUIET 100 | ||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730722202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057013418 | ||||||||
| FaxNumber: | 4057013451 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 04/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 24506 | OK | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 200173660A | 05 | OK | MEDICAID |