Individual
LUVEY DEATHERAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
36640 OLD HWY 270, WEWOKA, OK 74884
(405) 257-6282
Mailing address
15951 LITTLE AXE DR, NORMAN, OK 73026-9088
(405) 447-0300
(405) 701-7914
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2839
OK
Other
Enumeration date
01/26/2018
Last updated
03/04/2019
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