Individual
DR. DEBORAH SUE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1140 MAYBERRY DR, TAHLEQUAH, OK 74464-4603
(918) 453-1108
(918) 453-2019
Mailing address
PO BOX 1126, TAHLEQUAH, OK 74465-1126
(918) 453-1108
(918) 453-2019
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16198
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100825420C
—
OK
Enumeration date
01/13/2006
Last updated
03/02/2012
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