Provider Demographics
NPI:1336194307
Name:KUKAS, LAURIE ANN (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:KUKAS
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1024 NW 47TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6412
Mailing Address - Country:US
Mailing Address - Phone:405-528-0303
Mailing Address - Fax:405-528-0677
Practice Address - Street 1:1024 NW 47TH ST
Practice Address - Street 2:STE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6412
Practice Address - Country:US
Practice Address - Phone:405-528-0303
Practice Address - Fax:405-528-0677
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-06-29
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Provider Licenses
StateLicense IDTaxonomies
OK27042080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics