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NPI Code Detail

MEDICARE: JORDAN KEITH JONES

MEDICARE:   JORDAN KEITH JONES
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1336723238
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN KEITH JONES
Provider Business Mailing Address
First Line : 2241 WESTCHESTER DR
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-4827
Country : US
Telephone Number : 405-406-3450
Fax Number :
Provider Business Practice Location Address
First Line : 9201 S I 35 SERVICE RD
Second Line :
City : MOORE
State : OK
Zip : 73160-9046
Country : US
Telephone Number : 405-601-4303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2021
Last Update Date : 05/07/2021

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Directions to “ JORDAN KEITH JONES ” Practice Location

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