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NPI Code Detail

MEDICARE: JAY OAKS D.O.

MEDICARE: JAY OAKS D.O.
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
12086S0129XVascular Surgery PhysicianOS018429PA

General Provider Information

NPI Number : 1790786085
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY OAKS D.O.
Provider Business Mailing Address
First Line : 7800 NW 85TH TER
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73132-3385
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5224 E I 240 SERVICE RD STE 303
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73135-2607
Country : US
Telephone Number : 405-608-3800
Fax Number : 405-972-7259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 10/25/2022

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