Jeff E Northcutt MD PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

22394 Issued in OK

Legal business name

JEFF E NORTHCUTT MD PLLC

Practice address

1908 N 14TH St Ste 206
Ponca City, OK 74601-2039

Phone

(580) 762-8045

Fax

(580) 762-2798

NPI assigned

Jan 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeff E Northcutt, M.D.

Title

Owner

Phone

(580) 762-8045

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1154475887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N 14TH ST STE 206",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012039",
            "telephone_number": "580-762-8045",
            "fax_number": "580-762-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N 14TH ST STE 206",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012039",
            "telephone_number": "580-762-8045",
            "fax_number": "580-762-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF E NORTHCUTT MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "NORTHCUTT",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-762-8045",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "22394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200058550A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dianne Marise Jeans
• Jared W Jefferis
• Heather Marie Jeffries
• Thomas Jenkins, PTA
• Carol M. Jensen-Fry
• Yvonne Michelle Jensen

• Specialist in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.