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NPI Code Detail

MEDICARE: JOVITA GRACE PHILIP

MEDICARE:   JOVITA GRACE PHILIP
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1750196200
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOVITA GRACE PHILIP
Provider Business Mailing Address
First Line : 7732 S VICTOR AVE APT 20D
Second Line :
City : TULSA
State : OK
Zip : 74136-7717
Country : US
Telephone Number : 331-226-5870
Fax Number :
Provider Business Practice Location Address
First Line : 6216 S LEWIS AVE STE 102
Second Line :
City : TULSA
State : OK
Zip : 74136-1075
Country : US
Telephone Number : 918-268-7365
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2025
Last Update Date : 02/11/2025

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Directions to “ JOVITA GRACE PHILIP ” Practice Location

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