NPI 1104997436 · live from the CMS NPI Registry
Jeffery Allen Barentine, PA-C
Physician Assistant in Coweta, OK. National Provider Identifier 1104997436, active.
NPI record
| NPI | 1104997436 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 28622 E 141st St S, Coweta, OK 74429 |
| Practice phone | 918-486-7425 |
| Mailing address | 28622 E 141st St S, Po Box 1030, Coweta, OK 74429 |
| Enumerated | November 10, 2006 |
| Last updated | January 6, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 1567 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.