Individual
JESUS E MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 NE 10TH ST # 4200, OKLAHOMA CITY, OK 73104-5417
(405) 271-7559
Mailing address
1122 NE 13TH ST, ORI236, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
14989
OK
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
14989
OK
Other
Enumeration date
03/09/2006
Last updated
04/20/2018
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