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Organization

LAWTON EMERGENCY GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization

Contact information

Practice address
5602 SW LEE BLVD, LAWTON, OK 73505-9635
(580) 531-4700
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363AM0700X
Medical Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200111780A
OK
Enumeration date
01/29/2007
Last updated
03/23/2022
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