Provider Demographics
NPI:1881637890
Name:JARRETT, PAMELA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANN
Last Name:JARRETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 S FALCON AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74019-2237
Mailing Address - Country:US
Mailing Address - Phone:918-341-1000
Mailing Address - Fax:
Practice Address - Street 1:1910 S FALCON AVE
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74019-2237
Practice Address - Country:US
Practice Address - Phone:918-341-1000
Practice Address - Fax:918-403-6310
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3468208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93836Medicare UPIN