Individual
MR. JIMMY L KLUTTS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2220 W IOWA AVE, CHICKASHA, OK 73018-2738
(405) 224-2300
Mailing address
2220 W IOWA AVE, CHICKASHA, OK 73018-2738
(405) 779-2113
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0062493
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4447005008-001
BCBS
OK
01
—
7751127
AETNA
OK
Enumeration date
09/16/2005
Last updated
07/08/2007
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