Provider Demographics
NPI:1073376547
Name:HARGROVE, JOHN PAUL (BA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:HARGROVE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:PAUL
Other - Last Name:HARGROVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:2000 S MUSTANG RD APT 3504
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-0343
Mailing Address - Country:US
Mailing Address - Phone:405-274-5691
Mailing Address - Fax:
Practice Address - Street 1:2000 S MUSTANG RD APT 3504
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0343
Practice Address - Country:US
Practice Address - Phone:405-274-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist