Individual
JERI CLARK GOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA - C
Contact information
Practice address
3807 S PEORIA AVE, SUITE G AND H, TULSA, OK 74105-3145
(918) 359-7845
(918) 359-7849
Mailing address
1612 S COLLEGE AVE, TULSA, OK 74104-5233
(918) 902-0434
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
408
OK
Other
Enumeration date
11/21/2006
Last updated
03/25/2020
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