1699923847 NPI number — MS. JESSICA ELIZABETH MCGHEE M.D.

Table of content: MS. JESSICA ELIZABETH MCGHEE M.D. (NPI 1699923847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699923847 NPI number — MS. JESSICA ELIZABETH MCGHEE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGHEE
Provider First Name:
JESSICA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699923847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 268838
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73126-8838
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-619-4400
Provider Business Mailing Address Fax Number:
918-619-4334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4444 E 41ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-619-4400
Provider Business Practice Location Address Fax Number:
918-619-4334
Provider Enumeration Date:
08/29/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  2011014307 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0206X , with the licence number: 26466 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1699923847 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200224410A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".