Riley, Jillian Ross
Riley, Jillian Ross is an sole proprietor health care provider with primary practice located at 1011 Honor Heights Dr , Muskogee OK 74401-1318. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Riley, Jillian Ross can be contacted via phone (918) 577-4050.Contact Information
Primary practice address
1011 Honor Heights Dr
Muskogee OK 74401-1318
Phone: (918) 577-4050
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36052 | Oklahoma |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4553 | Oklahoma |
Profile Details
NPI number | 1619153574 |
---|---|
LBN Legal business name | Riley, Jillian Ross |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 10th, 2008 |
Last updated | Dec 10th, 2021 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619153574 | NPPES |
Oklahoma | MEDICAID | 200129340A |
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