Beller, Jack Juan

Beller, Jack Juan is an individual health care provider with primary practice located at 3301 Nw 50Th St , Oklahoma City OK 73112-5627. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Other Service Providers / Specialist is his primary health care specialty. Beller, Jack Juan can be contacted via phone (405) 947-0911.

Contact Information

Primary practice address
3301 Nw 50Th St Oklahoma City OK 73112-5627
Phone: (405) 947-0911
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 9412 Oklahoma
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 9412 Oklahoma
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 9412 Oklahoma

Profile Details

NPI number 1437157344
LBN Legal business name Beller, Jack Juan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Sep 7th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437157344 NPPES
Oklahoma MEDICAID 100110450A
Oklahoma Other P00777384

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