Individual
JACOB QUE BYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 MARY BAILEY, CHICKASHA, OK 73018-1832
(405) 224-2100
(405) 779-2143
Mailing address
2100 W IOWA AVE, CHICKASHA, OK 73018-2736
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
40117
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201170900A
—
OK
Enumeration date
04/10/2018
Last updated
10/10/2024
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