Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DEZJUAN VONTE JACKSON
Active Sole ProprietorDEZJUAN VONTE JACKSON is a Prosthetic/Orthotic Supplier healthcare provider located in OKLAHOMA CITY, Oklahoma. NPI 1679073183 is currently active in the NPPES registry. Verify at CMS.
Prosthetic/Orthotic Supplier · OKLAHOMA CITY, OK
Registration Details
- NPI Number
- 1679073183
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 20, 2018 (8.5021105876587 yrs)
- Last Updated
- Feb 20, 2018
- License
-
314007 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
10461 N MAY AVEOKLAHOMA CITY, OK, 731202610Browse OK providers · Browse ZIP 73120
- Phone
- 4055436314
- Primary Specialty
-
Prosthetic/Orthotic Supplier
335E00000X
- Additional Specialty
- Prosthetic/Orthotic Supplier
Other Prosthetic/Orthotic Supplier Providers in OKLAHOMA CITY, OK
| Name | Credential | NPI |
|---|---|---|
| MS. GLENNA J FRAWNER | — | 1508065756 |
| ALONDRA JULIAN MITCHELL | — | 1245924307 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.