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NPI 1538413687

NPI 1538413687 : JOSHUA JAMAR MCGEE : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1538413687
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA JAMAR MCGEE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/27/2012
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    Last Update Date     |    10/27/2012
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Provider Practice Location Address
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    Address Line         |    1917 S 82ND EAST AVE 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74112-7501
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    Country              |    US
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    Telephone            |    580-284-4860
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1917 S 82ND EAST AVE 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74112-7501
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    Country              |    US
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    Telephone            |    580-284-4860
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171W00000X
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    Taxonomy Name        |    Contractor
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    License Number       |    
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    License Number State |    
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