Provider Demographics
NPI:1417646639
Name:ALLTON, JOCELYN ANNETTE
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:ANNETTE
Last Name:ALLTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JOCELYN
Other - Middle Name:ANNETTE
Other - Last Name:HEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1316 NW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-4020
Mailing Address - Country:US
Mailing Address - Phone:405-215-7351
Mailing Address - Fax:
Practice Address - Street 1:1316 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-4020
Practice Address - Country:US
Practice Address - Phone:405-215-7351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist