Organization
JERRY C BOUMAN DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY BOUMAN MD (PHYSICIAN)
(918) 296-0900
Entity
Organization
Contact information
Practice address
715 W MAIN ST, SUITE H, JENKS, OK 74037-3554
(918) 296-0900
(918) 296-0985
Mailing address
PO BOX 21568, TULSA, OK 74121-1568
(918) 296-0900
(918) 296-0985
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2996
OK
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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