Jacob Anderson
Individual provider Active NPI Case Manager/Care Coordinator · Durant, OK
NPI 1104351709 · NPPES record last updated Apr 21, 2017
Key facts
- NPI
- 1104351709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 142 W Main St
Durant, OK 74701-5008 - Phone
- (580) 920-2069
- Fax
- (580) 920-1010
- NPI assigned
- Apr 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
142 W Main St
Durant, OK 74701-5008
Mailing address
142 W Main St
Durant, OK 74701-5008
Phone (580) 920-2069
Other providers in Durant, OK
- Kerlyn Omara Alonzo Juarez
- Krista Alshawish
- Always Better Care of Oklahoma, LLC
- Ashley K Anderson
- Britton Kyle Anderson
- Jessica Oneal Anderson
- Justin Eric Anderson
- Janice Andrews
- Mason Nicholas Andrews
- Sarah Marie Andrews
All providers in Durant, OK · Case Manager/Care Coordinator in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.