Provider Demographics
NPI:1033523220
Name:YOCUM, JESSICA MARIA (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIA
Last Name:YOCUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MARIA
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2820 N KELLY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-3015
Mailing Address - Country:US
Mailing Address - Phone:405-726-8000
Mailing Address - Fax:405-726-8101
Practice Address - Street 1:2820 N KELLY AVE STE 200
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-3015
Practice Address - Country:US
Practice Address - Phone:405-726-8000
Practice Address - Fax:405-726-8101
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK390200000X208000000X
OK30782208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics