Individual
JACQUELYN A O'BANION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
608 STANTON L YOUNG BLVD, OKLAHOMA CITY, OK 73104-5014
(405) 271-6060
(405) 271-1926
Mailing address
1365B CLIFTON RD NE, EMORY CLINIC BUILDING B, ATLANTA, GA 30322-1013
(404) 778-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27920
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200306430B
—
OK
Enumeration date
05/03/2009
Last updated
02/13/2017
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