Individual
JAYSON G CORTEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1522 SW 89TH ST, OKLAHOMA CITY, OK 73159-6307
(405) 691-6694
(405) 691-6404
Mailing address
1522 SW 89TH ST, OKLAHOMA CITY, OK 73159-6307
(405) 691-6694
(405) 691-6404
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
222
OK
213ES0131X
Foot Surgery Podiatrist
PD307R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1S4035
MEDICARE
OK
05
—
200995970A
—
OK
Enumeration date
08/09/2005
Last updated
06/15/2022
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