Individual
JASON W. DECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 S SAINT LOUIS AVE, TULSA, OK 74120-5440
(918) 619-4400
(918) 619-4696
Mailing address
1111 S SAINT LOUIS AVE, TULSA, OK 74120-5440
(918) 629-6207
(918) 619-4696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27889
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
27889
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200293050B
—
OK
Enumeration date
06/10/2010
Last updated
11/19/2024
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