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General NPI Number Information
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NPI Number | 1598388506
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Entity Type | Individual
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Provider Name | TALITHA JACOBS RRT
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 05/26/2020
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Provider Practice Location Address
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Address Line | 10109 E 79TH ST
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City | TULSA
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State | OK
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Zip | 74133-4564
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Country | US
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Telephone | 918-381-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 7878 E 126TH ST S APT 212
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City | BIXBY
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State | OK
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Zip | 74008-2379
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Country | US
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Telephone | 918-927-9004
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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 | 2279G1100X
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Taxonomy Name | General Care Registered Respiratory Therapist
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License Number | 4433
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License Number State | OK
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