Provider Demographics
NPI:1568254282
Name:DUFRENE, ETIENNE SOULE'
Entity type:Individual
Prefix:
First Name:ETIENNE
Middle Name:SOULE'
Last Name:DUFRENE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 NW DEARBORN AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-5735
Mailing Address - Country:US
Mailing Address - Phone:580-284-7522
Mailing Address - Fax:
Practice Address - Street 1:1616 NW DEARBORN AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-5735
Practice Address - Country:US
Practice Address - Phone:580-284-7522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist