Healthcare Provider Details

I. General information

NPI: 1932190204
Provider Name (Legal Business Name): LAWRENCE CHRISTOPHER DUROY PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 W MEMORIAL RD THIRD FLOOR
OKLAHOMA CITY OK
73120
US

IV. Provider business mailing address

7800 NW 85TH TER
OKLAHOMA CITY OK
73132-3385
US

V. Phone/Fax

Practice location:
  • Phone: 405-608-3800
  • Fax: 405-608-3838
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number912
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: