Individual
MR. CONNER JACOB MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
5310 E 31ST ST STE 300, TULSA, OK 74135-5012
(918) 584-4549
(918) 382-1886
Mailing address
14748 S FERN PL, GLENPOOL, OK 74033-2935
(918) 630-1711
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
M083765574
OK
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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