Individual
DR. LAURE G DEMATTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2821 36TH AVE NW STE 200, NORMAN, OK 73072-2477
(405) 515-2049
(405) 307-5630
Mailing address
PO BOX 1330, NORMAN, OK 73070-1330
(405) 735-2049
(405) 307-5630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
45995
WI
207QB0002X
Obesity Medicine (Family Medicine) Physician
53690
MN
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
5912
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006906261I
HUMANA
—
05
—
43508500
—
WI
Enumeration date
05/16/2006
Last updated
07/28/2021
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