Individual
GREGORY SHAWN PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, BHRS, CM
Contact information
Practice address
RR 1, BOX 35D, BOLEY, OK 74829
(918) 667-3367
(918) 667-3387
Mailing address
29501 KICKAPOO RD, MCLOUD, OK 74851-8320
(405) 964-1617
(405) 964-1759
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
#7173
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100685660A
—
OK
05
—
100685660B
—
OK
05
—
100685660D
—
OK
Enumeration date
11/08/2006
Last updated
12/09/2011
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