Individual
MR. JEROME P MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8121 NATIONAL AVE STE 200, MIDWEST CITY, OK 73110-7570
(405) 610-3023
(405) 737-8227
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13022
OK
207RC0000X
Cardiovascular Disease Physician
13022
OK
207RI0011X
Interventional Cardiology Physician
Primary
13022
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100056820A
—
OK
Enumeration date
09/16/2006
Last updated
06/06/2022
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