John V Tedesco DO PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

JOHN V TEDESCO DO PA

Practice address

209 S 36TH St
Suite a
Muskogee, OK 74401-5043

Phone

(918) 913-9513

Fax

(918) 913-9515

NPI assigned

Dec 4, 2012

Organization subpart

No

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

Authorized official

Name

John V Tedesco, DO

Title

Owner

Phone

(918) 913-9513

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1164767018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S 36TH ST",
            "address_2": "SUITE A",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015043",
            "telephone_number": "918-913-9513",
            "fax_number": "918-913-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S 36TH ST",
            "address_2": "SUITE A",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015043",
            "telephone_number": "918-913-9513",
            "fax_number": "918-913-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN V TEDESCO DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "TEDESCO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-913-9513",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.