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NPI Code Detail

MEDICARE: DR. JAYRONE GALERA CORTEZ D.C.

MEDICARE: DR. JAYRONE GALERA CORTEZ D.C.
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
1111N00000XChiropractor3849OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1232730304OTHEROKMEDICARE PTAN

General Provider Information

NPI Number : 1477746279
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAYRONE GALERA CORTEZ D.C.
Provider Business Mailing Address
First Line : 5108 W GORE BLVD
Second Line : SUITE 6
City : LAWTON
State : OK
Zip : 73505-6025
Country : US
Telephone Number : 580-353-5200
Fax Number : 580-353-5201
Provider Business Practice Location Address
First Line : 2640 MINER RD
Second Line :
City : FORT SILL
State : OK
Zip : 73503-4437
Country : US
Telephone Number : 580-585-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2007
Last Update Date : 01/31/2024

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