Douglas Wayne Jackson in Tulsa - Dentist
Douglas Wayne Jackson - NPI 1245367655
Douglas Wayne Jackson is a Dentist in Tulsa, Oklahoma. Douglas Wayne Jackson practices all healthcare services and medical treatments related to Dentist. The NPI Number for Douglas Wayne Jackson is 1245367655. The last update date is 2007-07-08.
Douglas Wayne Jackson's current location address is 5540 S 79th E Place, Tulsa, Oklahoma. You can contact this provider via phone number 9186630284. The mailing address for Douglas Wayne Jackson is 5540 S 79th E Place, Tulsa, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Douglas Wayne Jackson |
|---|---|
| Address | 5540 S 79th E Place, Tulsa, Oklahoma |
| Phone Number | 9186630284 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1245367655 |
|---|---|
| Provider Enumeration Date | 2007-02-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5540 S 79th E Place |
|---|---|
| City | Tulsa |
| State | Oklahoma (OK) |
| Post Code | 741457846 |
| Phone Number | 9186630284 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 3534 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the Douglas Wayne Jackson's 1245367655?
The Douglas Wayne Jackson's NPI (National Provider Identifier) Number is 1245367655. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Douglas Wayne Jackson located?
The Douglas Wayne Jackson is located at 5540 S 79Th E Place, Tulsa, OK 741457846.
What is the Douglas Wayne Jackson's specialty and taxonomy code?
The Douglas Wayne Jackson's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1245367655 to Douglas Wayne Jackson?
The Douglas Wayne Jackson received its 1245367655 assignment from the Centers for Medicare & Medicaid Services on 2007-02-27.
When was the information pertaining to Douglas Wayne Jackson most recently updated or revised?
The details related to Douglas Wayne Jackson, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.