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General NPI Number Information
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NPI Number | 1740576842
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Entity Type | Organization
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Legal Business Name | PAMELA R. GARNER D.O. PLLC
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 410 4TH ST SUITE K
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City | ALVA
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State | OK
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Zip | 73717-2372
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Country | US
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Telephone | 580-327-6880
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Fax | 580-327-6891
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Provider Business Mailing Address
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Address Line | 410 4TH ST SUITE K
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City | ALVA
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State | OK
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Zip | 73717-2372
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Country | US
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Telephone | 580-327-6880
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Fax | 580-327-6891
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. PAMELA R GARNER
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Credential | D.O.
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Telephone | 580-327-6880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4409
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License Number State | OK
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