Individual provider · Type 1 NPI

Elliss Desherow, DO

Student in an Organized Health Care Education/Training Program · Lawton, OK

NPI number 1073301206 Active

Practice location

3401 W Gore Blvd
Lawton, OK 73505-6332

Call (580) 355-8620 Map

Mailing address

38W155 Henricksen Rd
St. Charles, IL 60175-5471

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1073301206

Elliss Desherow, DO's National Provider Identifier is 1073301206, issued on Apr 28, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lawton, OK. The record was last updated on Apr 28, 2025.