Individual
JESSE E SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 310-8591
(405) 330-1811
Mailing address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 310-8591
(405) 330-1811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28005
OK
Other
Enumeration date
03/19/2010
Last updated
05/02/2018
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