Individual
OLIVIA ELIZABETH LUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
900 NE 10TH ST, OKLAHOMA CITY, OK 73104-5420
(405) 271-2330
Mailing address
900 NE 10TH ST, OKLAHOMA CITY, OK 73104-5420
(405) 271-2330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6441
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
OK
Other
Enumeration date
06/11/2017
Last updated
11/05/2020
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