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NPI Code Detail

MEDICARE: DILLON TREY JARRETT

MEDICARE:   DILLON TREY JARRETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1346720299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DILLON TREY JARRETT
Provider Business Mailing Address
First Line : 1413 SHALIMAR DR
Second Line :
City : DEL CITY
State : OK
Zip : 73115-4952
Country : US
Telephone Number : 504-410-4929
Fax Number :
Provider Business Practice Location Address
First Line : 1413 SHALIMAR DR
Second Line :
City : DEL CITY
State : OK
Zip : 73115-4952
Country : US
Telephone Number : 504-410-4929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2018
Last Update Date : 08/20/2018

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Directions to “ DILLON TREY JARRETT ” Practice Location

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