Jackey Leon Lindamood
Individual provider Active NPI Peer Specialist · Maud, OK
NPI 1285332007 · NPPES record last updated Feb 21, 2023
Key facts
- NPI
- 1285332007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 32018 Hwy 59-Ok
Maud, OK 74854 - Phone
- (405) 374-1225
- Fax
- (866) 201-3530
- NPI assigned
- Feb 21, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clay Crossing Foundation Inc | Past |
Accepting new patients | |
| Clay Crossing Foundation | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
32018 Hwy 59-Ok
Maud, OK 74854
Mailing address
PO Box 8
Maud, OK 74854-0008
Phone (405) 374-1225
Other providers in Maud, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2023. 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.