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Individual

PAUL L. TENNERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 341-7009
(405) 330-1811
Mailing address
4401 W MEMORIAL RD, SUITE #141; ATTN: TERRI, OKLAHOMA CITY, OK 73134-1785
(405) 936-5800
(405) 936-5211

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20071
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080149395
RAILROAD
OK
05
100135900A
OK
01
20071
LICENSE
OK
01
23422
OBNDD
OK
Enumeration date
06/24/2006
Last updated
05/18/2008
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