Individual
DR. JEROME ANTHONY MCTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, JD
Contact information
Practice address
2200 N CLASSEN BLVD, SUITE 1403, OKLAHOMA CITY, OK 73106-5800
(419) 461-1057
Mailing address
2200 N CLASSEN BLVD, SUITE 1403, OKLAHOMA CITY, OK 73106-5800
(419) 461-1057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2014015848
MO
207P00000X
Emergency Medicine Physician
Primary
30495
OK
Other
Enumeration date
07/09/2006
Last updated
11/20/2014
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