Individual
DR. CLAYTON DAVID DEJARNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10512 NORTH 110TH EAST AVENUE, OWASSO, OK 74055-6638
(918) 376-8900
(918) 272-7475
Mailing address
1145 S UTICA AVENUE, SUITE 110, TULSA, OK 74104-4013
(918) 579-3826
(918) 579-1262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1945
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123160B
—
OK
Enumeration date
06/29/2006
Last updated
04/06/2009
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