Individual
MR. JERRY EDWARD CARREL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 N.E.13TH, OKLAHOMA CITY, OK 73104
(405) 270-0501
Mailing address
2112 NE 15TH ST, MOORE, OK 73160-8625
(405) 799-5951
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA519
OK
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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