Individual
DR. ANTOINE I JABBOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Mailing address
4802 S 109TH E AVENUE, TULSA, OK 74146
(918) 392-1400
(918) 392-1488
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
17674
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096590A
—
OK
01
—
200036113
RAILROAD MEDICARE
OK
Enumeration date
03/10/2006
Last updated
02/08/2017
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