Provider Demographics
NPI:1356766836
Name:PEEPLES, JEREMY
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:PEEPLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5012
Mailing Address - Country:US
Mailing Address - Phone:918-600-3100
Mailing Address - Fax:918-560-1399
Practice Address - Street 1:4613 STATE ST
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2733
Practice Address - Country:US
Practice Address - Phone:918-758-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator