Individual
DALA R JAROLIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD FACP
Contact information
Practice address
1217 W MAIN ST, JENKS, OK 74037-2311
(918) 747-6673
(918) 296-8010
Mailing address
1217 W MAIN ST, JENKS, OK 74037-2311
(918) 747-6673
(918) 296-8010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11015
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094720D
—
OK
Enumeration date
01/26/2006
Last updated
07/29/2013
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