Provider Demographics
NPI:1982770699
Name:CAYGLE, LINDA LUCILLE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LUCILLE
Last Name:CAYGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 SOUTH 8TH
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-6719
Mailing Address - Country:US
Mailing Address - Phone:580-765-7964
Mailing Address - Fax:580-765-0668
Practice Address - Street 1:301 WEST GRAND AVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-5118
Practice Address - Country:US
Practice Address - Phone:580-765-4456
Practice Address - Fax:580-765-0668
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKT4103183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician