Individual
JEFFREY DEATHERAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 E MONROE AVE, MCALESTER, OK 74501-4815
(918) 429-4192
Mailing address
1101 E MONROE AVE, MCALESTER, OK 74501-4815
(918) 429-4192
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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