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NPI Code Detail

MEDICARE: CARLA J JONES DO

MEDICARE:   CARLA J JONES  DO
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 Physician3405OK
2207Q00000XFamily Medicine Physician3405OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2900522349OTHEROKMEDICARE GROUP PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487691234
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA J JONES DO
Provider Business Mailing Address
First Line : DEPT 1467
Second Line : MCN PRIMARY CLINICS
City : TULSA
State : OK
Zip : 74182-0001
Country : US
Telephone Number : 918-591-5700
Fax Number : 918-756-4490
Provider Business Practice Location Address
First Line : 1313 E 20TH ST
Second Line :
City : OKMULGEE
State : OK
Zip : 74447-6303
Country : US
Telephone Number : 918-591-5700
Fax Number : 918-756-4490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 04/27/2015

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Directions to “ CARLA J JONES DO” Practice Location

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