Provider Demographics
NPI:1508934431
Name:HILDEBRAND, JESSICA DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:DAWN
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S TELEPHONE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2969
Mailing Address - Country:US
Mailing Address - Phone:405-237-7500
Mailing Address - Fax:
Practice Address - Street 1:2900 S TELEPHONE RD STE 250
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2969
Practice Address - Country:US
Practice Address - Phone:405-237-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24769207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine