Provider Demographics
NPI:1053391672
Name:CHIAFFITELLI, JOHN JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:CHIAFFITELLI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:JOSEPH
Other - Last Name:CHIAFFITELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1616 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3600
Mailing Address - Country:US
Mailing Address - Phone:405-844-7888
Mailing Address - Fax:405-844-8881
Practice Address - Street 1:1601 SW 89TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6349
Practice Address - Country:US
Practice Address - Phone:405-681-2273
Practice Address - Fax:405-681-2274
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3345208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200008260AMedicaid
OK3345OtherLICENSE
OK246725401Medicare PIN