Individual
DR. KYLA MARIE LUSSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1755 N HIGHWAY 66, SUITE F, CATOOSA, OK 74015-2409
(918) 739-4885
(918) 739-4886
Mailing address
PO BOX 2035, CATOOSA, OK 74015-2926
(918) 739-4885
(918) 739-4886
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25858
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200208170A
—
OK
Enumeration date
06/29/2007
Last updated
07/09/2012
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