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1093711053
JAYSON D AVENMARG
POTEAU, OK
NPI
1093711053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: OK 27369)
Additional Taxonomies
208600000X Surgery
(Licence: CA A65237)
Enumeration Date
2005-06-23
Last Update Date
2010-03-16
Business Address
Dr. JAYSON D AVENMARG MD
104 WALL STREET
POTEAU, OK 74953
Phone number: 918-647-8635
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Mailing Address
Dr. JAYSON D AVENMARG MD
PO BOX 689
POTEAU, OK 74953
Phone number: 918-647-8635
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