Individual
DR. JERRY JEFF JABOIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 NE 10TH ST # OKCCL100, OKLAHOMA CITY, OK 73104-5418
(405) 271-5641
Mailing address
3181 SW SAM JACKSON PARK RD # L337, DEPARTMENT OF RADIATION MEDICINE, PORTLAND, OR 97239-3011
(503) 494-8756
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
2010015937
MO
2085R0001X
Radiation Oncology Physician
Primary
38749
OK
2085R0001X
Radiation Oncology Physician
MD174329
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578610382
—
MO
05
—
195048001
—
AR
01
—
431560263
TRICARE
MO
01
—
P01128079
RR MCR
MO
Enumeration date
01/04/2007
Last updated
03/30/2023
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