Individual
JACOB PALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1012 14TH AVE NW, ARDMORE, OK 73401-1807
(580) 226-1251
(580) 226-1254
Mailing address
1012 14TH AVE NW, ARDMORE, OK 73401-1807
(580) 226-1251
(580) 226-1254
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
113241
OK
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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