Healthcare Provider Details

I. General information

NPI: 1144131996
Provider Name (Legal Business Name): JASON VANPELT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2507 SE WASHINGTON BLVD
BARTLESVILLE OK
74006-7613
US

IV. Provider business mailing address

1561 SE BISON RD APT 1121
BARTLESVILLE OK
74006-7277
US

V. Phone/Fax

Practice location:
  • Phone: 539-242-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1499
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: