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NPI Code Detail

MEDICARE: JAMAL GEORGE

MEDICARE: JAMAL GEORGE
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1U084065323OTHEROKPRIVATE PAY

General Provider Information

NPI Number : 1184228579
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMAL GEORGE
Provider Business Mailing Address
First Line : 15725 CAPULET DR
Second Line :
City : EDMOND
State : OK
Zip : 73013-5059
Country : US
Telephone Number : 214-901-1487
Fax Number :
Provider Business Practice Location Address
First Line : 1737 LINWOOD BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-5037
Country : US
Telephone Number : 405-239-6815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2020
Last Update Date : 11/25/2020

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Directions to “ JAMAL GEORGE ” Practice Location

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