Provider Demographics
NPI:1578274239
Name:LAYMAN, DAEGAN PAUL
Entity Type:Individual
Prefix:
First Name:DAEGAN
Middle Name:PAUL
Last Name:LAYMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAEGAN
Other - Middle Name:PAUL
Other - Last Name:TASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1722 ROWENA LN
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4230
Mailing Address - Country:US
Mailing Address - Phone:405-312-5340
Mailing Address - Fax:
Practice Address - Street 1:2617 GENERAL PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6437
Practice Address - Country:US
Practice Address - Phone:405-858-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator