Provider Demographics
NPI:1831627611
Name:BUGG, VICTORIA ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANTONIO
Last Name:BUGG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:JUNE
Other - Last Name:ANTONIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:608 STANTON L YOUNG BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5065
Mailing Address - Country:US
Mailing Address - Phone:405-271-6060
Mailing Address - Fax:405-271-1926
Practice Address - Street 1:608 STANTON L YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5065
Practice Address - Country:US
Practice Address - Phone:405-271-6060
Practice Address - Fax:405-271-1926
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33021207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology