Jerry Allen Gooch

NPI 1083927057 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1083927057
Gender Male
Enumeration Date 07/20/2010
Last Updated 07/20/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
921 NE 13TH ST.
VA MEDICAL CENTER
OKLAHOMA CITY OK, 73104-5028, US
Phone (405) 795-3779
Fax
Business Location
RT 1 BOX 569
CASHION OK, 73016, US
Phone (405) 795-3779
Fax
Toxanomy
Taxonomy Code 367500000X
License State Oklahoma
License Number 64744
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According to our database, Mr. Jerry Allen Gooch NPI is 1083927057, taxonomy code is 367500000X and license number is 64744, license state is located at Oklahoma. Jerry Allen Gooch physically located at 921 Ne 13th St., Oklahoma City OK, 73104-5028. NPI Number Jerry Allen Gooch has the Individual type.

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1083927057 NPI number is provided on an as is basis without warranty of any kind. 1083927057 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Allen Gooch are for informational purposes only.