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General NPI Number Information
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NPI Number | 1518853712
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Entity Type | Individual
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Provider Name | LUCAS RAWLS
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Gender | Male
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 9600 BROADWAY EXT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-7408
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Country | US
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Telephone | 405-230-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 18817 GROVE PKWY
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City | EDMOND
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State | OK
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Zip | 73012-4499
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Country | US
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Telephone | 405-513-4211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number | R0137449
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 224707
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License Number State | OK
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