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:
Health care specialties
Specialty | Code | License # | 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 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1437157344 | NPPES |
Oklahoma | MEDICAID | 100110450A | |
Oklahoma | Other | P00777384 |
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