Basic Information
| Provider Information | |||||||||
| NPI: | 1457858813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAUFIELD | ||||||||
| FirstName: | LEA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MS, CHES | ||||||||
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| Mailing Information | |||||||||
| Address1: | DIABETES CARE CENTER - CHICKASAW NATION MEDICAL CENTER | ||||||||
| Address2: | 1921 STONECIPHER BLVD | ||||||||
| City: | ADA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5804363980 | ||||||||
| FaxNumber: | 5804214572 | ||||||||
| Practice Location | |||||||||
| Address1: | DIABETES CARE CENTER - CHICKASAW NATION MEDICAL CENTER | ||||||||
| Address2: | 1921 STONECIPHER BLVD | ||||||||
| City: | ADA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5804363980 | ||||||||
| FaxNumber: | 5804214572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2018 | ||||||||
| LastUpdateDate: | 04/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174H00000X | OK | Y | Other Service Providers | Health Educator |
No ID Information.