Individual
DR. JACOB BANNET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 ALAMEDA ST, NORMAN, OK 73071-5229
(405) 573-3955
(405) 573-3966
Mailing address
2501 SMOKING OAK RD, NORMAN, OK 73072-6713
(405) 360-8783
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18892
OK
2084P0802X
Addiction Psychiatry Physician
18892
OK
2084P0805X
Geriatric Psychiatry Physician
18892
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100035150A
—
OK
Enumeration date
10/11/2006
Last updated
11/10/2010
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