Individual
MR. JEREMY MICHAEL HURFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
124 N 6TH ST, OKEENE, OK 73763-9135
(580) 833-4404
(580) 822-4403
Mailing address
PO BOX 389, OKEENE, OK 73763-0389
(580) 822-4404
(580) 822-4403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2599
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471025ZL9Z
MEDICARE PTAN
OK
Enumeration date
11/11/2015
Last updated
10/28/2020
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