Individual
LUCAS FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(405) 694-6399
Mailing address
835 NW EUBANKS ST, OKLAHOMA CITY, OK 73118-7219
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
08/11/2025
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