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Individual

JONATHAN MARTIN ANTHONY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1145 S UTICA AVE, TULSA, OK 74104-4000
(918) 579-3646
Mailing address
3105 E 87TH PL, TULSA, OK 74137-2540
(918) 299-1859

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16732
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000892200
OK
Enumeration date
07/12/2006
Last updated
07/08/2007
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