Individual
JEREMY DANIEL PAYSNOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 N HARVARD AVE STE B, TULSA, OK 74115-4904
(918) 388-1901
Mailing address
5341 E 32ND PL, TULSA, OK 74135-5204
(405) 414-3937
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3025
OK
Other
Enumeration date
12/26/2018
Last updated
09/15/2021
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