Provider Demographics
NPI:1962843102
Name:JOHNS, DORIS JEAN
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:JEAN
Last Name:JOHNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:KREBS
Mailing Address - State:OK
Mailing Address - Zip Code:74554-0102
Mailing Address - Country:US
Mailing Address - Phone:918-424-4857
Mailing Address - Fax:
Practice Address - Street 1:100 N 5TH ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5084
Practice Address - Country:US
Practice Address - Phone:918-420-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker