Healthcare Provider Details

I. General information

NPI: 1427369958
Provider Name (Legal Business Name): ARIEL ERIK SANTOS LUFKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W MEMORIAL RD
OKLAHOMA CITY OK
73120-8304
US

IV. Provider business mailing address

530 N MONTE VISTA SUITE A
ADA OK
74820-4675
US

V. Phone/Fax

Practice location:
  • Phone: 405-752-3962
  • Fax: 405-752-3963
Mailing address:
  • Phone: 580-436-7101
  • Fax: 580-436-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30231
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number30231
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: