Healthcare Provider Details

I. General information

NPI: 1548640758
Provider Name (Legal Business Name): MELISSA JEAN JENNINGS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA JEAN BUGG

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 W ROCK CREEK RD STE 100
NORMAN OK
73072-2202
US

IV. Provider business mailing address

3650 W ROCK CREEK RD STE 100
NORMAN OK
73072-2202
US

V. Phone/Fax

Practice location:
  • Phone: 405-701-3418
  • Fax:
Mailing address:
  • Phone: 405-701-3418
  • Fax: 405-701-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number31605
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: