Provider Demographics
NPI:1376511964
Name:JARMAN, RANDALL WAYNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:WAYNE
Last Name:JARMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 E 97TH PL N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4345
Mailing Address - Country:US
Mailing Address - Phone:918-272-1570
Mailing Address - Fax:
Practice Address - Street 1:5525 E 51ST ST
Practice Address - Street 2:SUITE #400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7461
Practice Address - Country:US
Practice Address - Phone:918-712-0859
Practice Address - Fax:918-293-1031
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK647103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling