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General NPI Number Information
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NPI Number | 1841356797
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Entity Type | Individual
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Provider Name | JAYNA N SHEPHERD D.O.
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 7301 SW 44TH ST STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73179-4309
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Country | US
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Telephone | 405-357-3500
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Fax | 405-357-3519
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Provider Business Mailing Address
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Address Line | 5300 N INDEPENDENCE AVE SUITE 280
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-5556
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Country | US
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Telephone | 405-357-3500
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Fax | 405-357-3519
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4226
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License Number State | OK
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