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NPI Code Detail

MEDICARE: PAUL JOSEPH GARRETT

MEDICARE: PAUL JOSEPH GARRETT
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
1101YA0400XAddiction (Substance Use Disorder) CounselorT081846450OK

General Provider Information

NPI Number : 1851782221
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL JOSEPH GARRETT
Provider Business Mailing Address
First Line : 800 W CALIFORNIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-7807
Country : US
Telephone Number : 479-652-5366
Fax Number :
Provider Business Practice Location Address
First Line : 800 W CALIFORNIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-7807
Country : US
Telephone Number : 479-652-5366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2015
Last Update Date : 02/06/2015

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