Individual
JAMIE R MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3820
(918) 525-7236
Mailing address
1182 TURPIN LN, TAHLEQUAH, OK 74464-9759
(918) 871-8192
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
01/30/2026
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