Individual
JESS T ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7912 E 31ST CT, SUITE 220, TULSA, OK 74145-1315
(918) 743-8200
(918) 743-8609
Mailing address
7912 E 31ST CT, SUITE 100, TULSA, OK 74145-1315
(918) 743-8200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3989
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001840C
—
OK
01
—
G37001501
MEDICARE PIN
OK
Enumeration date
02/07/2006
Last updated
06/05/2018
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