Provider Demographics
NPI:1740273945
Name:DUBOIS, PEGGY CULVER (MD)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:CULVER
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1117 S DOUGLAS BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5262
Mailing Address - Country:US
Mailing Address - Phone:405-741-8686
Mailing Address - Fax:405-733-9621
Practice Address - Street 1:1117 S DOUGLAS BLVD
Practice Address - Street 2:STE D
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5262
Practice Address - Country:US
Practice Address - Phone:405-741-8686
Practice Address - Fax:405-733-9621
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2012-10-01
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Provider Licenses
StateLicense IDTaxonomies
OK12925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100128550AMedicaid
OK100128550AMedicaid