Provider Demographics
NPI:1578880225
Name:JUMELLE, PATRICIA EUGENIE (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:EUGENIE
Last Name:JUMELLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 S MEMORIAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4348
Mailing Address - Country:US
Mailing Address - Phone:918-872-6890
Mailing Address - Fax:918-403-6336
Practice Address - Street 1:8131 S MEMORIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4348
Practice Address - Country:US
Practice Address - Phone:918-872-6890
Practice Address - Fax:918-403-6336
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-9271207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program