Organization Name: | PAMELA R. GARNER D.O. PLLC |
NPI Number: | 1740576842 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAMELA R GARNER (OWNER/DOCTOR) |
Mailing Address: | 410 4th St Suite K Alva |
State: | OK US |
Postal Code: | 737172372 |
Phone Number: | 5803276880 |
Fax Number: | 5803276891 |
NPI Enumeration Date: | 06/27/2011 |
NPI Last Update Date: | 06/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4409 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |