Individual
CARLA J JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1313 E 20TH ST, OKMULGEE, OK 74447-6303
(918) 591-5700
(918) 756-4490
Mailing address
DEPT 1467, MCN PRIMARY CLINICS, TULSA, OK 74182-0001
(918) 591-5700
(918) 756-4490
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3405
OK
207Q00000X
Family Medicine Physician
3405
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100136620A
—
OK
01
—
900522349
MEDICARE GROUP PIN
OK
Enumeration date
06/01/2006
Last updated
04/27/2015
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