Individual
IAN JON DESPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ST
Contact information
Practice address
1809 E 13TH ST STE 400, TULSA, OK 74104-4431
(918) 599-8200
Mailing address
11911 E 20TH ST, TULSA, OK 74128-6419
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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