Organization
JEFF E NORTHCUTT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF E NORTHCUTT M.D. (OWNER)
(580) 762-8045
Entity
Organization
Contact information
Practice address
1908 N 14TH ST STE 206, PONCA CITY, OK 74601-2039
(580) 762-8045
(580) 762-2798
Mailing address
1908 N 14TH ST STE 206, PONCA CITY, OK 74601-2039
(580) 762-8045
(580) 762-2798
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22394
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200058550A
—
OK
Enumeration date
01/22/2007
Last updated
06/07/2011
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