Healthcare Provider Details

I. General information

NPI: 1568885416
Provider Name (Legal Business Name): OKLAHOMA SPINE AND MUSCULOSKELETAL MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 S WESTERN AVE STE 102
OKLAHOMA CITY OK
73139-1712
US

IV. Provider business mailing address

6510 S WESTERN AVE STE 102
OKLAHOMA CITY OK
73139-1712
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-5899
  • Fax: 405-601-5903
Mailing address:
  • Phone: 405-601-5899
  • Fax: 405-601-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number4871
License Number StateOK

VIII. Authorized Official

Name: DR. JONATHAN B. STONE
Title or Position: OWNER
Credential: D.O.
Phone: 405-601-5899