Individual
DR. ETHAN JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Mailing address
3401 W GORE BLVD, LAWTON, OK 73505-6332
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2022048662
MO
207P00000X
Emergency Medicine Physician
Primary
7284
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2020
Last updated
08/11/2025
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