Provider Demographics
NPI:1669272282
Name:CURTIS, JEFFREY RANDALL
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:RANDALL
Last Name:CURTIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 COAL CREEK ADDITION RD
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-9158
Mailing Address - Country:US
Mailing Address - Phone:903-556-8600
Mailing Address - Fax:
Practice Address - Street 1:477 COAL CREEK ADDITION RD
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-9158
Practice Address - Country:US
Practice Address - Phone:903-556-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider