Jacob Anderson
Case Manager/Care Coordinator in Durant, OK. Individual provider (NPI-1).
NPI number1104351709
StatusActive
Last updated in NPPESApr 21, 2017
Details
- NPI
- 1104351709
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jacob Anderson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 21, 2017
- Last updated
- Apr 21, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
142 W Main StDurant, OK 74701-5008
Phone 580-920-2069 · Fax 580-920-1010
Mailing address
142 W Main StDurant, OK 74701-5008
Phone 580-920-2069 · Fax 580-920-1010
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 101 Case Manager/Care Coordinator providers in Durant · All 1,274 providers in Durant
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