Healthcare Provider Details

I. General information

NPI: 1790697928
Provider Name (Legal Business Name): LUTHER WILSON MCGEE JR. FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 W GORE BLVD
LAWTON OK
73505-6305
US

IV. Provider business mailing address

3401 W GORE BLVD
LAWTON OK
73505-6332
US

V. Phone/Fax

Practice location:
  • Phone: 580-357-3280
  • Fax:
Mailing address:
  • Phone: 580-355-8620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231341
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: