Individual
LAMONT EDWARD CAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 S SAINT LOUIS AVE, TULSA, OK 74120-5440
(918) 619-4400
(918) 619-4639
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 619-4400
(918) 619-4639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
18457
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
18457
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100137310C
—
OK
Enumeration date
02/03/2006
Last updated
06/27/2023
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