Healthcare Provider Details

I. General information

NPI: 1649642919
Provider Name (Legal Business Name): ERIC RAMOS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W PAWNEE ST
CLEVELAND OK
74020-3020
US

IV. Provider business mailing address

4198 S HIGHWAY 99
JENNINGS OK
74038-2855
US

V. Phone/Fax

Practice location:
  • Phone: 918-358-3588
  • Fax:
Mailing address:
  • Phone: 405-514-5860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2597
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: