Individual
JACOB WILLIS WITMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4401 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3413
(305) 636-7195
Mailing address
3301 AUSTRIAN PINE LN, YUKON, OK 73099-3008
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6804
OK
Other
Enumeration date
04/04/2018
Last updated
06/26/2020
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