Individual
JAY ROBERT ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
591 E 36TH ST N, TULSA, OK 74106-1812
(918) 619-4400
(918) 634-7875
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 660-3632
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8830
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201325970A
—
OK
Enumeration date
03/26/2016
Last updated
04/03/2025
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