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General NPI Number Information
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NPI Number | 1740513084
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Entity Type | Organization
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Legal Business Name | JENNIFER R. CAMERON, M.D., P.C.
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 715 W MAIN ST SUITE P
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City | JENKS
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State | OK
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Zip | 74037-3554
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Country | US
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Telephone | 918-296-7045
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Fax | 918-518-5023
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Provider Business Mailing Address
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Address Line | PO BOX 1440
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City | JENKS
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State | OK
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Zip | 74037-1440
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Country | US
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Telephone | 918-296-7045
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Fax | 918-518-5023
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Authorized Official
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Title or Position | CODING/COMPLIANCE/CONTRACTING MANAG
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Name | MS. JULIA ANN BENHAM
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Credential | R.H.I.T.
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Telephone | 918-296-7045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23608
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License Number State | OK
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