Individual
JASON AARON GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1511
(918) 392-1488
Mailing address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1511
(918) 392-1488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1785
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200228760A
—
OK
Enumeration date
12/10/2008
Last updated
03/04/2011
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