Individual
MR. JEROME ANTONIE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3101 N LAIRD AVE, OKLAHOMA CITY, OK 73105-7628
(405) 213-8158
Mailing address
3101 N LAIRD AVE, OKLAHOMA CITY, OK 73105-7628
(405) 213-8158
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
R080262296
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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