DR. ANTOINE I JABBOUR (NPI# 1588632905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588632905 |
| Entity Type | Individual |
| Full Name | DR. ANTOINE I JABBOUR |
| Credential | MD |
| Practice Address |
4802 S 109th East Ave Tulsa OK 74146-5822 |
| Mailing Address |
4802 S 109th E Avenue Tulsa OK 74146 |
| Practice Telephone | 9183921400 |
| Practice Fax Number | 9183921488 |
| Mailing Telephone | 9183921400 |
| Mailing Fax Number | 9183921488 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2017-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
17674 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | RAILROAD MEDICARE | 200036113 | 01 |
| OK | 100096590A | 05 |
| Street Address |
4802 S 109TH EAST AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74146-5822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275500415 | Jaafar M Bazih | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2006-03-07 |
| 1285294710 | Tbj Advanced Care LLC | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2019-06-17 |
| 1003391905 | Rebecca Holland | Physician Assistant | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2018-09-27 |
| 1730685314 | Johnathon David Millwee | Specialist/Technologist | 4802 S 109th East Ave, Tulsa, OK 74146 | 2018-04-03 |
| 1124400064 | Craig Stewart | Physical Therapist | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2015-06-28 |
| 1396155222 | Rey Amezquita | Orthotist | 4802 S 109th East Ave, Brace Shop, Tulsa, OK 74146-5822 | 2014-04-30 |
| 1700223070 | Thomas Calvin Blair IIi | Physical Therapist | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2013-05-28 |
| 1396082137 | Ashley Linn Legg | Physician Assistant | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2013-01-14 |
| 1417251372 | Luis Hernandez | Physician Assistant | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2011-01-06 |
| 1720306277 | Jason Griffin | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2010-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922624550 | Sage Anesthesia Services Inc. | Nurse Anesthetist, Certified Registered | Union Pines Surgery Center, 4808 S 109th E Ave, Tulsa, OK 74146 | 2020-06-19 |
| 1811401631 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 5230 S Mingo Rd, Tulsa, OK 74146 | 2017-12-01 |
| 1184158404 | Alexis Lauren Allen | Case Manager/Care Coordinator | 9820 E 41st St #400, Tulsa, OK 74146 | 2017-04-13 |
| 1578995908 | Adrian Gheorghe Butuc | Massage Therapist | 5635 S Mingo #b, Tulsa, OK 74146 | 2013-08-08 |
| 1336587088 | Tulsa Cancer Institute, Pllc | Obstetrics & Gynecology | 12697 E. 51st St. South, Tulsa, OK 74146 | 2013-06-04 |
| 1265782338 | Milestones Pediatric Urgent Care | Pediatrics | 3863 South 103rd E Avenue, Tulsa, OK 74146 | 2012-09-14 |
| 1619232972 | Diagnostic Imaging Associates | General Acute Care Hospital | 4500 S Garnett Rd, Ste 300, Tulsa, OK 74146 | 2012-07-11 |
| 1790046654 | Aundra Lamar Fuller | Behavioral Analyst | 10922 E. 39th St., Tulsa, OK 74146 | 2012-06-06 |
| 1134492416 | Mark S Thomas Jr. | Behavioral Analyst | 10005 E 52nd Street, Tulsa, OK 74146 | 2012-02-16 |
| 1922307958 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 5115 S. 122nd East Ave., Suite 204, Tulsa, OK 74146 | 2011-03-16 |
| Find all providers in zip 74146 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891709747 | James Clarke Mayoza | Orthopaedic Surgery | 6122 E 61st St, Tulsa, OK 74136-2117 | 2006-07-28 |
| 1649561713 | Chad Hanson | Orthopaedic Surgery | 1809 E 13th St, Tulsa, OK 74104-4419 | 2011-04-25 |
| 1730201682 | John C. Balbas | Orthopaedic Surgery | 4802 S 109th East Ave, Tulsa, OK 74146-5822 | 2007-04-04 |
| 1841339785 | Andrew B Ebert | Orthopaedic Surgery | 6475 S Yale Ave Ste 200, Tulsa, OK 74136-7816 | 2007-02-06 |
| 1710955901 | Kevin M Dukes | Orthopaedic Surgery | 4802 S 109th E Ave, Tulsa Bone and Joint Associates, Tulsa, OK 74146 | 2006-03-14 |
| 1043210305 | Eastern Oklahoma Orthopedic Center Inc | Orthopaedic Surgery | 6475 S Yale Ave, Ste. 301, Tulsa, OK 74136-7815 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942659982 | Orthopedic Solutions Pllc | Orthopaedic Surgery | 101 S Saints Blvd, Suite 101, Edmond, OK 73034-3081 | 2016-06-09 |
| 1548620529 | Ortho Plus Holdings LLC | Orthopaedic Surgery | 1730 Shedeck Parkway, Ste 105, Yukon, OK 73099 | 2016-03-03 |
| 1962861625 | Ortho Plus, LLC | Orthopaedic Surgery | 941 W I 35 Frontage Rd, Ste A-d, Edmond, OK 73034-7364 | 2016-02-23 |
| 1396076022 | Small Properties Lc | Orthopaedic Surgery | 2007 N Commerce St Ste 201, Ardmore, OK 73401-1394 | 2010-01-20 |
| 1437393931 | Neal Charles Small | Orthopaedic Surgery | 2007 N Commerce St, Suite 201, Ardmore, OK 73401-1268 | 2009-04-28 |
| 1558415240 | Oklahoma Orthopedics & Sports Medicine | Orthopaedic Surgery | 1533 N Harrison St, Shawnee, OK 74804-4011 | 2007-01-22 |
| 1316010150 | Orthopedic Center of Muskogee | Orthopaedic Surgery | 3900 West Broadway, Muskogee, OK 74401 | 2006-11-17 |
| 1962412569 | Gene L Muse | Orthopaedic Surgery | 4200 W Memorial Road, Ste 1001, Oklahoma City, OK 73120 | 2006-08-08 |
| 1326049719 | Brett C Barnes | Orthopaedic Surgery | 110 Nw 31st St Fl 2, Lawton, OK 73505-6100 | 2005-08-09 |
| 1194198192 | Northeastern State University | Orthopaedic Surgery | 603 N Grand Ave, Tahlequah, OK 74464-2302 | 2015-11-12 |
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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.