Provider Demographics
NPI:1063756708
Name:MATHEWS, JOJIN ANGELO (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOJIN
Middle Name:ANGELO
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:JOJIN
Other - Middle Name:ANGELO
Other - Last Name:JOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3347
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:918-488-6010
Practice Address - Street 1:6151 S YALE AVE
Practice Address - Street 2:SUITE 1-301
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1907
Practice Address - Country:US
Practice Address - Phone:918-502-3200
Practice Address - Fax:918-502-3205
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2360363A00000X
AZ5311363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant