Provider Demographics
NPI:1982872719
Name:PETE JONES MD INC
Entity Type:Organization
Organization Name:PETE JONES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD MSPH
Authorized Official - Phone:918-425-8600
Mailing Address - Street 1:PO BOX 703024
Mailing Address - Street 2:529 E 36TH ST N
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106
Mailing Address - Country:US
Mailing Address - Phone:918-425-8600
Mailing Address - Fax:918-425-3305
Practice Address - Street 1:529 E 36TH ST N
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106
Practice Address - Country:US
Practice Address - Phone:918-425-8600
Practice Address - Fax:918-425-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOKLAHOMA 18827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF67828Medicare UPIN