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Individual

CLAUDIA J TYBURSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
102 NW 31ST, LAWTON, OK 73505
(580) 353-6790
(580) 510-7019
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
18276
OK
207V00000X
Obstetrics & Gynecology Physician
5692302
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100176000B
OK
01
160039648
RAILROAD MEDICARE
01
5692302
AETNA
OK
Enumeration date
09/16/2005
Last updated
02/06/2008
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