JEFFREY LANE BLACK


Address: 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346
Phone: 9187487557

JEFFREY LANE BLACK (NPI# 1700957990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700957990
Entity Type Individual
Full Name JEFFREY LANE BLACK
Practice Address 1717 S Utica Ave Ste A
Tulsa
OK 74104-5346
Mailing Address 1515 N Harvard Ave
Ste E
Tulsa
OK 74115-4957
Practice Telephone 9187487557
Practice Fax Number 9187487514
Mailing Telephone 9188326049
Mailing Fax Number 9188326055
Enumeration Date 2006-11-11
Last Update Date 2010-04-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207PE0004X Emergency Medicine
Specialization: Emergency Medical Services
16468 OK Allopathic & Osteopathic Physicians

Other Providers JEFFREY BLACK

NPI Name Taxonomy Address Enumeration
1235419896 Jeffrey Allen Black Pharmacist 1925 Zero St, Fort Smith, AR 72901-8415 2011-08-26
1760474035 Jeffrey L. Black Radiology 418 30th St, Oakland, CA 94609-3302 2005-08-22
1336646629 Jeffrey Ryne Black General Practice 625 19th St S, Birmingham, AL 35233-1900 2018-04-12
1265854905 Jeffrey Black Pediatrics 2222 Welborn St, Dallas, TX 75219-3924 2014-01-15
1770920894 Jeffrey Black Technician 700 Chief Eddie Hoffman Highway, Bethel, AK 99559-0528 2013-05-30
1538137112 Jeffrey B Black Family Medicine 7205 265th St Nw, Stanwood, WA 98292-6221 2006-03-09

Office Location

Street Address 1717 S UTICA AVE STE A
City TULSA
State OK
Zip Code 74104-5346

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558359505 Richard P Holsopple II Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2005-10-12
1396380259 Kassandra D Delcoure Registered Nurse 1717 S Utica Ave Ste A, Tulsa, OK 74104-5342 2019-11-14
1588172415 Kristen Paige Smith Physician Assistant 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2018-01-12
1740796606 Virginia Corcoran Physician Assistant 1717 S Utica Ave Ste A, Tulsa, OK 74104 2017-12-14
1366976391 Adrienne Taren Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2017-04-17
1801331871 Karen Gwen Smith Registered Nurse 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2016-12-30
1366822033 Rebecca Massey Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2015-06-08
1578950671 Robyn Lovitt Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104 2015-04-16
1063801660 John Clay Bowen Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2015-01-20
1386046753 Ricky Atwood Nurse Practitioner 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2014-09-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982253811 Ultimate Health and Pain Management Pain Medicine 1844 East 15th Street, Tulsa, OK 74104 2019-09-04
1225691223 David Murray Student in an Organized Health Care Education/Training Program 2100 S Wheeling Ave, Tulsa, OK 74104 2019-04-16
1083115828 Susan Fortner Counselor 1328 S. Delaware Pl, Tulsa, OK 74104 2018-02-27
1033636915 Mark Brizendine Dietitian, Registered Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 2017-08-23
1295259067 Demi Reyd Cook Nurse Practitioner 1717 A South Utica, Tulsa, OK 74104 2017-08-02
1851827059 Oklahoma Cvs Pharmacy Durable Medical Equipment & Medical Supplies 1701 E 15th Street, Tulsa, OK 74104 2017-05-08
1801334982 Jamie Lynne Miller Internal Medicine 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 2017-02-08
1578913430 Donna Durant-macon Registered Nurse 315 South Utica, Tulsa, OK 74104 2016-06-21
1669833851 Mbc Dental Dentist 401 S. Utica Ave, #a, Tulsa, OK 74104 2016-03-15
1518332170 Neuro Dynamics LLC Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 22 S Lewis, Tulsa, OK 74104 2015-12-08
Find all providers in zip 74104

Taxonomy Information

Taxonomy Code 207PE0004X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine
Specialization Emergency Medical Services

Taxonomy Definition

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326149048 Nadim N Daher Emergency Medicine 802 S Jackson Ave Ste 310, Tulsa, OK 74127-9057 2006-09-26
1134186299 Boyd David Burns Emergency Medicine 4502 E. 41st St, Tulsa, OK 74135-9923 2006-05-01
1649235532 Stephen R Gilliland Emergency Medicine 8813 S 71st East Ave, Tulsa, OK 74133-5056 2006-04-20
1841260015 Joseph M. Nicholson IIi Emergency Medicine 1435 S Utica Ave, Tulsa, OK 74104-4649 2006-01-23
1225018757 Stanley R Stacy Emergency Medicine 7153 S Yale Ave, Tulsa, OK 74136-6308 2006-01-19
1255321162 Joe D Sagely Emergency Medicine 1217 E 48th St, Tulsa, OK 74105 2005-10-24
1245220144 Jason A. Logan Emergency Medicine 7600 S Lewis Ave, Tulsa, OK 74136-6836 2005-10-24
1558359505 Richard P Holsopple II Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2005-10-12
1508424755 Tulsa Ep, Pllc Emergency Medicine 717 W. 71st Street, Tulsa, OK 74132 2019-06-03
1063801660 John Clay Bowen Emergency Medicine 1717 S Utica Ave Ste A, Tulsa, OK 74104-5346 2015-01-20
Find all providers in TULSA

Competitor

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City TULSA
Zip Code 74104

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Dataset Information

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.

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