Provider Demographics
NPI:1538212832
Name:WEBB, JON CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:CHRISTOPHER
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1425 E LINCOLN RD
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-7345
Mailing Address - Country:US
Mailing Address - Phone:580-286-4323
Mailing Address - Fax:580-286-4324
Practice Address - Street 1:1425 E LINCOLN RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-7345
Practice Address - Country:US
Practice Address - Phone:580-286-4323
Practice Address - Fax:580-286-4324
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2010-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK159882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD42916Medicare UPIN