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JERRY HANSON PUCKETT MD NPI 1366441115


NPI Information

NPI: 1366441115
Provider Name: JERRY HANSON PUCKETT, MD
Classification: Otolaryngology - 207Y00000X
Entity Type: Individual
Address:
6475 S YALE AVE STE 401
TULSA, OK
ZIP 74136
Phone: (918) 502-9555
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Jerry Hanson Puckett, MD is an otolaryngology in Tulsa, OK. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. Jerry Hanson Puckett, MD NPI is 1366441115. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6475 S YALE AVE STE 401
TULSA, OK
ZIP 74136-818
Phone: (918) 502-9555
Fax: (918) 502-9559

The enumeration date for this NPI number is 7/14/2005 and was last updated on 4/13/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngology12175OKLAHOMAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100078700AMEDICAIDOKLAHOMA

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

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