Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 21125 | ME |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 37344 | OK |
NPI | 1437440278 |
---|---|
Provider Name | Dr. Jessica Ann Faught |
First Address | Oklahoma City, OK 73103-2612 |
Second Address | Oklahoma City, OK 73103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2011 |
Last Update Date | 21/01/2021 |