Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 5757 | OK |
NPI | 1003001785 |
---|---|
Provider Name | Dr. Jaclyn Cinda Jones |
First Address | Tulsa, OK 74104-4431 |
Second Address | Tulsa, OK 74104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2007 |
Last Update Date | 13/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200593280A | (05) | OK |