Active NPI
Jack T Dancer I, M.D.
- Surgery Physician
- Stillwater, OK
National Provider Identifier
1235212630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 7845
- Practice address
- 1301 W 6TH Ave
Suite 105
Stillwater, OK 74074-4375 - Phone
- (405) 533-1074
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 7845 | OK | Primary |
Addresses
Primary practice location
1301 W 6TH Ave
Suite 105
Stillwater, OK 74074-4375
Mailing address
1301 W 6TH Ave
Suite 105
Stillwater, OK 74074-4375
Phone (405) 533-1074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235212630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 W 6TH AVE",
"address_2": "SUITE 105",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740744375",
"telephone_number": "405-533-1074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 W 6TH AVE",
"address_2": "SUITE 105",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740744375",
"telephone_number": "405-533-1074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANCER",
"first_name": "JACK",
"middle_name": "T",
"name_suffix": "I",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "7845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.