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NPI Code Detail

MEDICARE: SEAN T PAQUETTE PA-C

MEDICARE: SEAN T PAQUETTE PA-C
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
1363A00000XPhysician Assistant5748OK
2363AS0400XSurgical Physician AssistantPA21427CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14292600001OTHERCADME SUPPLIER NUMBER

General Provider Information

NPI Number : 1881824209
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN T PAQUETTE PA-C
Provider Business Mailing Address
First Line : 18632 E CROOKED OAK DR
Second Line :
City : OWASSO
State : OK
Zip : 74055-5047
Country : US
Telephone Number : 916-943-8117
Fax Number :
Provider Business Practice Location Address
First Line : 6161 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-1902
Country : US
Telephone Number : 916-943-8117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2009
Last Update Date : 12/30/2025

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Directions to “ SEAN T PAQUETTE PA-C” Practice Location

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