Provider Demographics
NPI:1871721787
Name:HIJAZI, JEFF JN (DC)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:JN
Last Name:HIJAZI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JEHAD
Other - Middle Name:N
Other - Last Name:HIJAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3560 S BOULEVARD
Mailing Address - Street 2:STE 100
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5413
Mailing Address - Country:US
Mailing Address - Phone:405-340-0007
Mailing Address - Fax:
Practice Address - Street 1:3560 S BOULEVARD
Practice Address - Street 2:STE 100
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5413
Practice Address - Country:US
Practice Address - Phone:405-340-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor