Provider Demographics
NPI:1235509340
Name:TEVEBAUGH, JON (DVM)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:
Last Name:TEVEBAUGH
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61950 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:OK
Mailing Address - Zip Code:73728-5503
Mailing Address - Country:US
Mailing Address - Phone:580-596-3500
Mailing Address - Fax:580-596-3501
Practice Address - Street 1:61950 GRANT RD
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:OK
Practice Address - Zip Code:73728-5503
Practice Address - Country:US
Practice Address - Phone:580-596-3500
Practice Address - Fax:580-536-3501
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4022174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian