# RYLAN-JAGGER MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SANTA FE CLINIC OF EDMOND
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316127913
- **Authorized official:** DATHAN D JAY MD (PRESIDENT)
- **Authorized official phone:** (405) 513-7070

## Contact information

- **Practice address:** 523 S SANTA FE AVE, EDMOND, OK 73003-6226
- **Practice address phone:** (405) 513-7070
- **Practice address fax:** (405) 513-7071
- **Mailing address:** PO BOX 99112, OKLAHOMA CITY, OK 73199-0001
- **Mailing address phone:** (405) 513-7070
- **Mailing address fax:** (405) 513-7071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/12/2007
- **Last updated:** 05/29/2008