Active NPI
Lesa J Bethel Mulligan MD PC
- Medical Specialty Clinic/Center
- Norman, OK
National Provider Identifier
1669506507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- Legal business name
- LESA J BETHEL MULLIGAN MD PC
- Practice address
- 1139 36TH Ave NW Ste 100
Norman, OK 73072-4104 - Phone
- (405) 364-0643
- Fax
- (405) 364-0502
- NPI assigned
- Mar 15, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Ann M Hopkins
- Title
- Insurance Coordinator
- Phone
- (405) 364-0643
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | Primary |
Addresses
Primary practice location
1139 36TH Ave NW Ste 100
Norman, OK 73072-4104
Mailing address
1139 36TH Ave NW Ste 100
Norman, OK 73072-4104
Phone (405) 364-0643
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100131240B | Other | OK | SOONERCARE |
| 100131240B | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D1027372 | Lesa J Mulligan MD | Provider-performed microscopy | Jun 27, 2028 |
National Provider Directory
National Provider DirectoryLocations
1139 36th Ave NW
Ste 100
Norman, OK 73072
Phone (405) 217-9997
1139 36th Ave NW
Norman, OK 73072
Phone (405) 364-0643
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Lawton, OK
- NPI 1063518520
-
- Obstetrics & Gynecology Physician
- Norman, OK
- NPI 1255395984
-
- Specialist
- Bartlesville, OK
- NPI 1598795973
-
- Obstetrics & Gynecology Physician
- Oklahoma City, OK
- NPI 1801837596
-
- Obstetrics & Gynecology Physician
- Oklahoma City, OK
- NPI 1275886459
-
- Obstetrics & Gynecology Physician
- Altus, OK
- NPI 1134354640
-
- Nurse Practitioner
- Oklahoma City, OK
- NPI 1619538469
-
- Obstetrics & Gynecology Physician
- Norman, OK
- NPI 1780625756
-
- Obstetrics & Gynecology Nurse Practitioner
- Cincinnati, OH
- NPI 1881651479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747958400000",
"number": "1669506507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1139 36TH AVE NW STE 100",
"city": "NORMAN",
"state": "OK",
"postal_code": "730724104",
"telephone_number": "405-364-0643",
"fax_number": "405-364-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1139 36TH AVE NW STE 100",
"city": "NORMAN",
"state": "OK",
"postal_code": "730724104",
"telephone_number": "405-364-0643",
"fax_number": "405-364-0502"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LESA J BETHEL MULLIGAN MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-15",
"last_updated": "2025-05-23",
"certification_date": "2025-05-23",
"status": "A",
"authorized_official_last_name": "HOPKINS",
"authorized_official_first_name": "ANN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "INSURANCE COORDINATOR",
"authorized_official_telephone_number": "405-364-0643",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOONERCARE",
"identifier": "100131240B",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100131240B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.