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NPI Code Detail

MEDICARE: JACK BAIR MD

MEDICARE: JACK BAIR MD
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
1207P00000XEmergency Medicine Physician14272OK

General Provider Information

NPI Number : 1134100290
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK BAIR MD
Provider Business Mailing Address
First Line : 4500 S GARNETT RD
Second Line : STE 919
City : TULSA
State : OK
Zip : 74146-5229
Country : US
Telephone Number : 918-728-6145
Fax Number :
Provider Business Practice Location Address
First Line : 700 NE 13TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-5004
Country : US
Telephone Number : 405-378-2197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 12/21/2012

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Directions to “ JACK BAIR MD” Practice Location

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