Healthcare Provider Details

I. General information

NPI: 1366262792
Provider Name (Legal Business Name): STEVEN NGUYEN LAFAYETTE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 SW LEE BLVD
LAWTON OK
73505-8312
US

IV. Provider business mailing address

2609 SW LEE BLVD
LAWTON OK
73505-8312
US

V. Phone/Fax

Practice location:
  • Phone: 580-248-5242
  • Fax: 580-280-4483
Mailing address:
  • Phone: 580-248-5242
  • Fax: 580-280-4483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1176R
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: