Basic Information
| Provider Information | |||||||||
| NPI: | 1376511964 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JARMAN | ||||||||
| FirstName: | RANDALL | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10707 E 97TH PL N | ||||||||
| Address2: | |||||||||
| City: | OWASSO | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740554345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182721570 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5525 E 51ST ST | ||||||||
| Address2: | SUITE #400 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741357461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187120859 | ||||||||
| FaxNumber: | 9182931031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 01/22/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC1900X | 647 | OK | Y | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.