MEDICARE: JORDAN HUNT

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
1	225100000X	Physical Therapist	6675	OK

General Provider Information

NPI Number	:	1659242923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN HUNT

Provider Business Mailing Address
First Line	:	777 NW 63RD ST FL 4
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-7601
Country	:	US
Telephone Number	:	405-231-3837
Fax Number	:	405-272-7977

Provider Business Practice Location Address
First Line	:	9060 HARMONY DR STE A
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6253
Country	:	US
Telephone Number	:	405-610-8090
Fax Number	:	405-610-8097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	09/17/2025

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