Individual
PATRICK JERALD OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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