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General NPI Number Information
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NPI Number | 1780703900
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Entity Type | Individual
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Provider Name | JEREMIAH A JANSEN MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 3330 NW 56TH SUITE 206
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City | OKLA CITY
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State | OK
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Zip | 73112-4426
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Country | US
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Telephone | 405-945-4710
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Fax | 405-562-9242
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Provider Business Mailing Address
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Address Line | 3330 NW 56TH SUITE 206
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City | OKLA CITY
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State | OK
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Zip | 73112-4426
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Country | US
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Telephone | 405-945-4710
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Fax | 405-562-9242
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA11337600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C175919
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | TEP5419
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25857
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License Number State | OK
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