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Organization

JETT SURGICAL PRACTICE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MASON PECK JETT MD (PRESIDENT)
(405) 605-6880
Entity
Organization

Contact information

Practice address
3330 NW 56TH ST, STE 616, OKLAHOMA CITY, OK 73112-4479
(405) 605-6880
(405) 605-6881
Mailing address
3330 NW 56TH ST, STE 616, OKLAHOMA CITY, OK 73112-4479
(405) 605-6880
(405) 605-6881

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10480
OK

Other

Enumeration date
03/09/2012
Last updated
03/09/2012
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