Individual
DR. LISA DUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4444 E 41ST ST, 3RD FLOOR, STE A, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4152
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 619-4400
(918) 619-4152
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15640
OK
207R00000X
Internal Medicine Physician
29711
CO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
15640
OK
Other
Enumeration date
07/06/2012
Last updated
02/13/2015
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