Provider Demographics
NPI:1700141116
Name:PALMORE, JOHN ROBERT JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:PALMORE
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3347
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:
Practice Address - Street 1:2950 S ELM PL
Practice Address - Street 2:SUITE 120
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7877
Practice Address - Country:US
Practice Address - Phone:918-451-5191
Practice Address - Fax:918-451-5272
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2014-11-11
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant