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General NPI Number Information
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NPI Number | 1710988233
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Entity Type | Individual
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Provider Name | JAYSON G CORTEZ DPM
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 1522 SW 89TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-6307
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Country | US
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Telephone | 405-691-6694
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Fax | 405-691-6404
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Provider Business Mailing Address
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Address Line | 1522 SW 89TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-6307
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Country | US
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Telephone | 405-691-6694
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Fax | 405-691-6404
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 222
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PD307R
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License Number State | LA
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