Provider Demographics
NPI:1003001785
Name:JONES, JACLYN CINDA (DO)
Entity Type:Individual
Prefix:DR
First Name:JACLYN
Middle Name:CINDA
Last Name:JONES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1809 E 13TH ST STE 402
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4431
Mailing Address - Country:US
Mailing Address - Phone:918-579-2300
Mailing Address - Fax:918-579-2309
Practice Address - Street 1:1245 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104
Practice Address - Country:US
Practice Address - Phone:918-579-2590
Practice Address - Fax:918-579-2599
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5757207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200593280AMedicaid