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NPI Code Detail

MEDICARE: JANE CK FITCH

MEDICARE:   JANE CK FITCH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician22646OK

General Provider Information

NPI Number : 1063480689
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE CK FITCH
Provider Business Mailing Address
First Line : 1122 NE 13TH ST
Second Line : ORI 236
City : OKLAHOMA CITY
State : OK
Zip : 73117-1039
Country : US
Telephone Number : 405-271-1515
Fax Number :
Provider Business Practice Location Address
First Line : 920 STANTON L YOUNG BLVD
Second Line : WP2530
City : OKLAHOMA CITY
State : OK
Zip : 73104-5020
Country : US
Telephone Number : 405-271-4351
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 07/03/2008

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Directions to “ JANE CK FITCH ” Practice Location

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