# JENKS HEALTH TEAM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891982625
- **Authorized official:** DR. GERALD D WOOTAN D.O. (OWNER)
- **Authorized official phone:** (918) 299-9447

## Contact information

- **Practice address:** 715 W MAIN ST, SUITE S, JENKS, OK 74037-3554
- **Practice address phone:** (918) 299-9447
- **Practice address fax:** (918) 299-5325
- **Mailing address:** 715 W MAIN ST, SUITE S, JENKS, OK 74037-3554
- **Mailing address phone:** (918) 299-9447
- **Mailing address fax:** (918) 299-5325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2007
- **Last updated:** 09/25/2007