Individual
TARA GLEAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3500 S WESTERN AVE, OKLAHOMA CITY, OK 73109-2413
(405) 632-5565
(405) 632-3538
Mailing address
3500 S WESTERN AVE, OKLAHOMA CITY, OK 73109-2413
(405) 632-5565
(405) 632-3538
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1727
OK
Other
Enumeration date
04/25/2008
Last updated
09/04/2013
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