Individual
DUC M TU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 N LEE AVE, SUITE 235, OKLAHOMA CITY, OK 73103-2600
(405) 272-6580
(405) 272-6590
Mailing address
PO BOX 268986, OKLAHOMA CITY, OK 73126-8986
(405) 231-3857
(405) 272-7977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17179
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100222720B
—
OK
Enumeration date
07/06/2006
Last updated
10/21/2020
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