Individual
JEANIE L. KLABZUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5201 W MEMORIAL RD, OKLAHOMA CITY, OK 73142-2016
(405) 755-4050
(405) 752-1553
Mailing address
5201 W MEMORIAL ROAD, OKLAHOMA CITY, OK 73142-2004
(405) 755-4050
(405) 749-9566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4229
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070030A
—
OK
01
—
33605
OBNDD
OK
01
—
4229
LICENSE
OK
Enumeration date
06/16/2006
Last updated
06/06/2017
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