Individual
DR. JESSE DEWAYNE GEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4318 W OKMULGEE ST, MUSKOGEE, OK 74401-4648
(918) 686-0471
(918) 686-0369
Mailing address
4318 W OKMULGEE ST, MUSKOGEE, OK 74401-4648
(918) 686-0471
(918) 686-0369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2144
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100087920A
—
OK
Enumeration date
06/17/2005
Last updated
11/20/2014
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