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NPI Code Detail

MEDICARE: JAYSON G CORTEZ DPM

MEDICARE: JAYSON G CORTEZ DPM
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
1213ES0131XFoot Surgery Podiatrist222OK
2213ES0131XFoot Surgery PodiatristPD307RLA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11S4035OTHEROKMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710988233
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYSON G CORTEZ DPM
Provider Business Mailing Address
First Line : 1522 SW 89TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-6307
Country : US
Telephone Number : 405-691-6694
Fax Number : 405-691-6404
Provider Business Practice Location Address
First Line : 1522 SW 89TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-6307
Country : US
Telephone Number : 405-691-6694
Fax Number : 405-691-6404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 06/15/2022

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