Provider Demographics
NPI:1134395940
Name:J FREDERICK MCNEER MD PLLC
Entity type:Organization
Organization Name:J FREDERICK MCNEER MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:MCNEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-809-4304
Mailing Address - Street 1:6585 S YALE AVE STE 317
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8344
Mailing Address - Country:US
Mailing Address - Phone:918-809-4304
Mailing Address - Fax:918-749-5456
Practice Address - Street 1:6585 S YALE AVE STE 317
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8344
Practice Address - Country:US
Practice Address - Phone:918-809-4304
Practice Address - Fax:918-749-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2500X, 261QP2300X
OK11650207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE11016Medicare UPIN