Individual
JESSICA MARIE FAZENDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 NE 10TH ST STE 4G, OKLAHOMA CITY, OK 73104-5417
(405) 271-5789
(405) 271-1643
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
45139
OK
2086X0206X
Surgical Oncology Physician
38362
AL
Other
Enumeration date
06/19/2013
Last updated
11/27/2025
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