Basic Information
| Provider Information | |||||||||
| NPI: | 1407444888 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUGGAN | ||||||||
| FirstName: | CALEB | ||||||||
| MiddleName: | ANDREW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 608 NW 9TH ST STE 1100 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731021015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052313000 | ||||||||
| FaxNumber: | 4052313073 | ||||||||
| Practice Location | |||||||||
| Address1: | 17620 CRANBROOK RD | ||||||||
| Address2: | |||||||||
| City: | EDMOND | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730126954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4055932108 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/01/2021 | ||||||||
| LastUpdateDate: | 04/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0000 | OK | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.