MEDICARE: DR. JONATHAN EDWARD MCGHEE M.D.

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	207Q00000X	Family Medicine Physician	25885	OK

General Provider Information

NPI Number	:	1912104829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN EDWARD MCGHEE M.D.

Provider Business Mailing Address
First Line	:	6316 E 102ND ST FL 1
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-7061
Country	:	US
Telephone Number	:	918-600-2333
Fax Number	:	918-600-2234

Provider Business Practice Location Address
First Line	:	6316 E 102ND ST FL 1
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-7061
Country	:	US
Telephone Number	:	918-600-2333
Fax Number	:	918-600-2234

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	09/22/2021

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