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NPI Profile for JESI M TATUM in PAWHUSKA, OK.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Administrator |
163WA2000X |
| NPI Number | 1730416652 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/13/2009 | |
| Last updated | 10/16/2014 - About 12 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JESI M TATUM
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JESI M TATUM