Provider Demographics
NPI:1992772917
Name:CHATZIGIANNIDIS, JONIS (LPED, DOMP, MT)
Entity type:Individual
Prefix:
First Name:JONIS
Middle Name:
Last Name:CHATZIGIANNIDIS
Suffix:
Gender:M
Credentials:LPED, DOMP, MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 S YALE AVE
Mailing Address - Street 2:SUITE 608
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-747-8224
Mailing Address - Fax:918-296-3587
Practice Address - Street 1:6465 S YALE AVE STE 608
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7808
Practice Address - Country:US
Practice Address - Phone:918-747-8224
Practice Address - Fax:918-935-3499
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26222Z00000X, 224L00000X, 225000000X, 174400000X
246ZE0600X
OK157326225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist