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Organization

JOHN V TEDESCO DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN V TEDESCO DO (OWNER)
(918) 913-9513
Entity
Organization

Contact information

Practice address
209 S 36TH ST, SUITE A, MUSKOGEE, OK 74401-5043
(918) 913-9513
(918) 913-9515
Mailing address
209 S 36TH ST, SUITE A, MUSKOGEE, OK 74401-5043
(918) 913-9513
(918) 913-9515

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OK

Other

Enumeration date
12/04/2012
Last updated
12/04/2012
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