Jantzen Josef Faulkner, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9189 Issued in OK

Practice address

1400 Bryan Dr Ste 201
Durant, OK 74701-2157

Phone

(580) 924-5500

Fax

(580) 924-1991

NPI assigned

Oct 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1669198149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BRYAN DR STE 201",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012157",
            "telephone_number": "580-924-5500",
            "fax_number": "580-924-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BRYAN DR STE 201",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012157",
            "telephone_number": "580-924-5500",
            "fax_number": "580-924-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "JANTZEN",
        "middle_name": "JOSEF",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-17",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "9189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenna Everheart
• Excel Therapy Specialists, LLC
• Family Care Center of Durant PC
• Mindy Fancher
• Diane Joan Farar
• Alissa Jade Lynn Feb-Winters, B.S.
• Alexis Elizabeth Feltman
• Tiffany R Ferguson, DO
• Jenna Mae Fielder
• Venita Fielder

• Family Medicine Physician in Durant, OK
• Providers in Durant, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.