Provider Demographics
NPI:1558192195
Name:OKLAHOMA WOUND CARE JJ PC
Entity type:Organization
Organization Name:OKLAHOMA WOUND CARE JJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:479-685-8837
Mailing Address - Street 1:8211 E REGAL PL STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7181
Mailing Address - Country:US
Mailing Address - Phone:305-733-3811
Mailing Address - Fax:
Practice Address - Street 1:8211 E REGAL PL STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7181
Practice Address - Country:US
Practice Address - Phone:305-733-3811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty