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Individual

DR. JYOTI CHANDRAKANT JAGTAP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(276) 806-8549
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27657
OK
207R00000X
Internal Medicine Physician
DOO61106
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200395750A
OK
Enumeration date
09/05/2006
Last updated
10/07/2014
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