Individual
JEWELL L DANIELS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4200 W OKMULGEE ST, MUSKOGEE, OK 74401-4646
(918) 683-5025
(918) 913-9703
Mailing address
4200 W OKMULGEE ST, MUSKOGEE, OK 74401-4646
(918) 683-5025
(918) 913-9703
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
23095
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200039920A
—
OK
Enumeration date
03/31/2006
Last updated
04/22/2013
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