Individual
MR. JOHN THOMAS PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2002 12TH AVE NW, SUITE B, ARDMORE, OK 73401-1206
(580) 223-5180
(580) 223-5184
Mailing address
2002 12TH AVE NW, SUITE B, ARDMORE, OK 73401-1206
(580) 223-5180
(580) 223-5184
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2395
OK
363AS0400X
Surgical Physician Assistant
2395
OK
Other
Enumeration date
11/03/2006
Last updated
07/11/2014
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