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NPI Code Detail

MEDICARE: JEFFREY JANKOWSKI P.T. AND A.T.C.

MEDICARE: JEFFREY JANKOWSKI P.T. AND A.T.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer154OK
2225100000XPhysical Therapist2549OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12782216OTHEROKCIGNA
29606006OTHEROKAETNA LEGACY

General Provider Information

NPI Number : 1083833651
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY JANKOWSKI P.T. AND A.T.C.
Provider Business Mailing Address
First Line : 800 NW 6TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-7241
Country : US
Telephone Number : 405-609-3667
Fax Number : 405-609-3697
Provider Business Practice Location Address
First Line : 700 NW 7TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73102-1212
Country : US
Telephone Number : 405-609-3667
Fax Number : 405-609-3697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 02/16/2022

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