Provider Demographics
NPI:1316283724
Name:PITTS, JEAN ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ANN
Last Name:PITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11177 NS 367 RD
Mailing Address - Street 2:
Mailing Address - City:OKEMAH
Mailing Address - State:OK
Mailing Address - Zip Code:74859-4437
Mailing Address - Country:US
Mailing Address - Phone:405-944-5998
Mailing Address - Fax:405-944-5768
Practice Address - Street 1:11177 NS 367 RD
Practice Address - Street 2:
Practice Address - City:OKEMAH
Practice Address - State:OK
Practice Address - Zip Code:74859-4437
Practice Address - Country:US
Practice Address - Phone:405-944-5998
Practice Address - Fax:405-944-5768
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9868207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease