Individual
JIM G MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3200 QUAIL SPRINGS PKWY, STE 200, OKLAHOMA CITY, OK 73134-2612
(405) 701-9880
(405) 701-9881
Mailing address
3200 QUAIL SPRINGS PKWY, STE 200, OKLAHOMA CITY, OK 73134-2612
(405) 701-9880
(405) 701-9881
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
3168
OK
2086S0129X
Vascular Surgery Physician
Primary
3168
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100130690A
—
OK
01
—
770001792
RAILROAD MEDICARE
OK
Enumeration date
10/04/2005
Last updated
11/18/2015
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