DR. OLEN LYNN JESTIS II (NPI# 1578794087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578794087 |
| Entity Type | Individual |
| Full Name | DR. OLEN LYNN JESTIS II |
| Credential | D.O. |
| Practice Address |
1610 W University Blvd Durant OK 74702-1610 |
| Practice Telephone | 5809243400 |
| Practice Fax Number | 5809242000 |
| Mailing Telephone | 5809243400 |
| Mailing Fax Number | 5809242000 |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2012-04-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4774 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1610 W UNIVERSITY BLVD |
| City | DURANT |
| State | OK |
| Zip Code | 74702-1610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992702724 | Terry M. Lee | Emergency Medicine | 1610 W University Blvd, Durant, OK 74701-3045 | 2005-07-07 |
| 1063910925 | Marshall County Hma LLC | Clinic/Center | 1610 W University Blvd, Durant, OK 74701-3096 | 2018-01-25 |
| 1487100558 | Jessica Oneal Anderson | Family Medicine | 1610 W University Blvd, Durant, OK 74701 | 2016-08-29 |
| 1093052078 | Osu Center for Health Sciences | Clinic/Center | 1610 W University Blvd, Durant, OK 74701-3096 | 2013-01-10 |
| 1295854180 | Lee Family Clinic | Durable Medical Equipment & Medical Supplies | 1610 W University Blvd, Durant, OK 74701-3045 | 2007-03-29 |
| 1487760633 | Georgia M. Banther | Dietitian, Registered | 1610 W University Blvd, Durant, OK 74701-3045 | 2006-08-21 |
| 1114952678 | Charles Powers | Physician Assistant | 1610 W University Blvd, Durant, OK 74701-3045 | 2006-07-12 |
| 1073558441 | Lee Family Clinic Inc | Family Medicine | 1610 W University Blvd, Durant, OK 74701-3045 | 2006-06-18 |
| 1326087800 | David M Lovelace | Emergency Medicine | 1610 W University Blvd, Durant, OK 74701-3096 | 2006-06-06 |
| 1629070388 | William J Harrison | Family Medicine | 1610 W University Blvd, Durant, OK 74701-3045 | 2005-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215139415 | Johnette L Routh | Nurse Practitioner | 1400 Bryan Dr, #300, Durant, OK 74702 | 2007-06-01 |
| 1376581314 | Seetha Devi Sureddi | Obstetrics & Gynecology | 1400 Bryan Dr, Suite 300, Durant, OK 74702 | 2006-06-03 |
| 1780621052 | Koteswar Rao Sureddi | Family Medicine | 1400 Bryan Dr, Suite 300, Durant, OK 74702 | 2006-06-02 |
| 1528019569 | Grant Roesler | Nurse Anesthetist, Certified Registered | 1400 Bryan Drive, Durant, OK 74702 | 2006-05-15 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144585639 | Alexander C Roby | Family Medicine | 5109 Valley View Dr, Durant, OK 74701-7742 | 2012-07-10 |
| 1629332952 | Timothy Ryan Newton | Family Medicine | 424 N 2nd Ave, Durant, OK 74701-4116 | 2012-07-02 |
| 1417036104 | Tiffany Dawn Burke | Family Medicine | 1312 N 1st Ave, Durant, OK 74701-2810 | 2006-11-03 |
| 1497843676 | Wirt Fletcher Shrock Jr. | Family Medicine | 630 Northwest Ave, Durant, MS 39063-3337 | 2006-10-11 |
| 1962432625 | Gastorf Family Clinic PC | Family Medicine | 1004 N 19th Ave Bldg 2, Durant, OK 74701-3017 | 2006-07-05 |
| 1952339558 | Kd Family Care Center Pllc | Family Medicine | 720 Bryan Dr, Suite A, Durant, OK 74701-7032 | 2006-06-30 |
| 1669467312 | Phyllis Pyrum Engles | Family Medicine | 1802 Radio Rd, Durant, OK 74701-2006 | 2005-09-19 |
| 1619961943 | Chris L Sturch | Family Medicine | 1727 Chuckwa Dr, Suite 500, Durant, OK 74701-2151 | 2005-09-01 |
| 1821090572 | David W Dillow | Family Medicine | 1600 W University Blvd, Durant, OK 74701-3094 | 2005-08-12 |
| 1124020193 | Michael A Lee | Family Medicine | 1708 Delivery Lane, Durant, OK 74701-3016 | 2005-08-10 |
| Find all providers in DURANT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.