Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 192 | OK |
N | 111NR0200X | Radiology | 192 | OK |
N | 213ER0200X | Radiology | 192 | OK |
N | 213ES0103X | Foot & Ankle Surgery | 192 | OK |
NPI | 1013915701 |
---|---|
Provider Name | Jeff Robert Finkenstaedt |
First Address | Tulsa, OK 74135-1500 |
Second Address | Tulsa, OK 74135-1526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 16/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100780500A | (05) | OK |
U61468 | (02) |