Rose, Jody Gene

Rose, Jody Gene is an sole proprietor health care provider with primary practice located at 4400 Grant Blvd Ste 110 , Yukon OK 73099-0038. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Rose, Jody Gene can be contacted via phone (405) 733-1711.

Contact Information

Primary practice address
4400 Grant Blvd Ste 110 Yukon OK 73099-0038
Phone: (405) 733-1711
Fax: (405) 733-3111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 204 Oklahoma
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 204 Oklahoma

Profile Details

NPI number 1184623001
LBN Legal business name Rose, Jody Gene
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2005
Last updated Aug 21st, 2023 - about 3 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 1184623001 NPPES
Oklahoma Other 200522012 MEDICARE GROUP
Oklahoma Other P00010135 MEDICARE GROUP

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