Individual
JACQUELINE PETRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6565 S YALE AVE STE 312, TULSA, OK 74136-8304
(918) 502-7050
(918) 502-7055
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 832-6055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16104
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000074870A
—
OK
Enumeration date
06/07/2006
Last updated
11/13/2023
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