Provider Demographics
NPI:1528365616
Name:DUGUAY, LACI L (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LACI
Middle Name:L
Last Name:DUGUAY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-773-6470
Mailing Address - Fax:405-773-6462
Practice Address - Street 1:5915 W MEMORIAL RD STE 300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-2022
Practice Address - Country:US
Practice Address - Phone:405-773-6470
Practice Address - Fax:405-773-6462
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2021-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK1982363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant