Healthcare Provider Details

I. General information

NPI: 1659287134
Provider Name (Legal Business Name): COLT JONES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 S 109TH EAST AVE
TULSA OK
74146-5822
US

IV. Provider business mailing address

6502 S YALE AVE STE 3410
TULSA OK
74136-8342
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-1400
  • Fax: 918-392-1401
Mailing address:
  • Phone: 918-499-4855
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7143
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: