Individual
MS. JEANNE ALICE RODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
525 SW 80TH ST, SUITE 200, OKLAHOMA CITY, OK 73139
(405) 631-0481
(405) 631-9025
Mailing address
525 SW 80TH ST, SUITE 200, OKLAHOMA CITY, OK 73139
(405) 631-0481
(405) 631-9025
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1115
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100191990A
—
OK
01
—
970018299
RAILROAD MEDICARE
OK
Enumeration date
04/26/2006
Last updated
08/21/2019
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