DR. JACK JUAN BELLER M.D. NPI 1437157344

NPI Information

NPI: 1437157344
Provider Name: DR. JACK JUAN BELLER, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3301 NW 50TH ST
OKLAHOMA CITY, OK
ZIP 73112
Phone: (405) 947-0911
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DR. Jack Juan Beller, M.D. is a specialist in Oklahoma City, OK with 54 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Jack Juan Beller, M.D. NPI is 1437157344. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduation Year:1970

The provider's business location address is:

3301 NW 50TH ST
OKLAHOMA CITY, OK
ZIP 73112-627
Phone: (405) 947-0911

The NPI 1437157344 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 9/7/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207X00000X	Orthopaedic Surgery		9412	OKLAHOMA	No
2	207XX0005X	Orthopaedic Surgery	Sports Medicine	9412	OKLAHOMA	No
3	174400000X	Specialist		9412	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	247609001	MEDICARE PIN	OKLAHOMA
2	100110450A	MEDICAID	OKLAHOMA
3	D34392	MEDICARE UPIN	OKLAHOMA
4	P00777384	OTHER	OKLAHOMA	MCR RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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