Individual
PAMELA E AHEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
714 HIGHWAY 70 E, KINGSTON, OK 73439
(580) 564-0200
(580) 564-0201
Mailing address
5012 US HWY 75 S, SUITE 300, ATT: BILLING, DENISON, TX 75020
(580) 920-2273
(580) 920-9978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19862
OK
207Q00000X
Family Medicine Physician
L2077
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102140B
—
OK
Enumeration date
07/26/2005
Last updated
07/13/2018
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