Individual
MR. DWAYNE LEWIS ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 STRAKA TER, OKLAHOMA CITY, OK 73139-2544
(405) 632-6688
(405) 604-0708
Mailing address
1025 STRAKA TER, OKLAHOMA CITY, OK 73139-2544
(405) 632-6688
(405) 604-0708
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19836
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100126030B
—
OK
Enumeration date
09/01/2006
Last updated
03/07/2023
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