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Lonnie Jackson
NPI 1659703569 · on the registry since 2013
Practice
- Address
- 8901 S. Sante Fe Ave
Oklahoma City, OK 73139 - Phone
- (405) 605-5757
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-08-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma