Provider Demographics
NPI:1588397368
Name:RAMIREZ, JESUS JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:JR
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3121 WHITE TAIL DR
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-7812
Mailing Address - Country:US
Mailing Address - Phone:405-696-9252
Mailing Address - Fax:
Practice Address - Street 1:304 S PARK LN
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-5753
Practice Address - Country:US
Practice Address - Phone:580-379-6500
Practice Address - Fax:580-379-6509
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK4847363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant