Individual
JEFFERY ALLEN BARENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
28622 E 141ST ST S, COWETA, OK 74429-7515
(918) 486-7425
(918) 279-6884
Mailing address
28622 E 141ST ST S, PO BOX 1030, COWETA, OK 74429-7515
(918) 486-7425
(918) 279-6884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1567
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072574
NCCPA
OK
01
—
1567
OKLAHOMA STATE LICENSE
OK
Enumeration date
11/10/2006
Last updated
01/06/2010
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