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NPI Code Detail

MEDICARE: JORDAN M. MCAULIFF PA-C

MEDICARE: JORDAN M. MCAULIFF PA-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
1363AS0400XSurgical Physician Assistant1315OK
2363A00000XPhysician Assistant1315OK

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 : 1679556104
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN M. MCAULIFF PA-C
Provider Business Mailing Address
First Line : 2488 E 81ST ST STE 290
Second Line :
City : TULSA
State : OK
Zip : 74137-4265
Country : US
Telephone Number : 918-927-3226
Fax Number : 918-927-3193
Provider Business Practice Location Address
First Line : 2488 E 81ST ST STE 290
Second Line :
City : TULSA
State : OK
Zip : 74137-4265
Country : US
Telephone Number : 918-494-2665
Fax Number : 918-927-3201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 02/07/2021

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Directions to “ JORDAN M. MCAULIFF PA-C” Practice Location

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