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NPI Code Detail

MEDICARE: MRS. LACI L DUGUAY P.A.-C

MEDICARE: MRS. LACI L DUGUAY P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1982OK

General Provider Information

NPI Number : 1528365616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LACI L DUGUAY P.A.-C
Provider Business Mailing Address
First Line : 5300 N INDEPENDENCE AVE STE 280
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5555
Country : US
Telephone Number : 405-773-6470
Fax Number : 405-773-6462
Provider Business Practice Location Address
First Line : 5915 W MEMORIAL RD STE 300
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2022
Country : US
Telephone Number : 405-773-6470
Fax Number : 405-773-6462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2011
Last Update Date : 02/22/2021

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Directions to “ MRS. LACI L DUGUAY P.A.-C” Practice Location

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