Provider Demographics
NPI:1912735721
Name:GOAD, JAYME C
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:C
Last Name:GOAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:C
Other - Last Name:REAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:909 JONES ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:HARTSHORNE
Mailing Address - State:OK
Mailing Address - Zip Code:74547-5119
Mailing Address - Country:US
Mailing Address - Phone:918-297-2518
Mailing Address - Fax:
Practice Address - Street 1:909 JONES ACADEMY RD
Practice Address - Street 2:
Practice Address - City:HARTSHORNE
Practice Address - State:OK
Practice Address - Zip Code:74547-5119
Practice Address - Country:US
Practice Address - Phone:918-297-2518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator