Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 201951 | LA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 29410 | OK |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD.201951 | LA |
NPI | 1114989753 |
---|---|
Provider Name | Joe Stephen Jones |
First Address | Tulsa, OK 74136-3347 |
Second Address | Tulsa, OK 74136-8327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 17/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1038741 | (05) | LA |
E07441 | (02) | |
E07441 | (02) | LA |