Individual
JASON D MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1501 N FLORENCE, STE 201, CLAREMORE, OK 74017-3189
(918) 341-1886
(918) 343-1727
Mailing address
1501 N FLORENCE, STE 201, CLAREMORE, OK 74017-3189
(918) 341-1886
(918) 343-1727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5044
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200493630A
—
OK
Enumeration date
06/03/2010
Last updated
02/22/2016
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