Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1801424346 Individual Practitioner Male Practitioner

Jack Manquen

Pediatrics • Tulsa, OK

Professional Overview & Biography Verified Profile Summary

Jack Manquen is a registered healthcare professional specializing in Pediatrics in Tulsa, OK. Practice services are available at 1724 S HARVARD AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1724 S Harvard Ave

Tulsa, OK 741126826

Telephone 4057306990
Fax 4057306992
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Tulsa, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.8 Yrs
State Avg: 22.7 Yrs
Regional Practice Density
164 Specialists

Practicing in Tulsa, OK (730 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-07-01
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OK 7329

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics - Sports Medicine

NUCC Taxonomy Code: 2080S0010X

State License AZ 010269

A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
NPI 1225614795

Doctor of Osteopathic Medicine (D.O.)

Mallory Gray , APRN

Nurse Practitioner - Family

NPI 1255963252

Advanced Practice Registered Nurse

Dr. Isaac Ilaoa , DO

Internal Medicine

NPI 1336415280

Doctor of Osteopathic Medicine (D.O.)

Dr. John Beavers , MD

Family Medicine

NPI 1386615839

Doctor of Medicine (M.D.)

Mary Grace Difuntorum , APRN, FNP

Nurse Practitioner - Family

NPI 1659078129

Advanced Practice Registered Nurse, Family Nurse Practitioner

Esperanza Duncan , APRN

Nurse Practitioner - Family

NPI 1689493348

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location July 01, 2025

Registered at 1724 S HARVARD AVE, TULSA, OK 741126826 (Tel: 4057306990)

📍
Updated Business Mailing Address July 01, 2025

Registered at 1706 S CEDAR AVE, BROKEN ARROW, OK 740126407 (Tel: 5862148344)

📍
Updated Business Mailing Address July 01, 2024

Registered at 2108 E THOMAS RD STE 130, PHOENIX, AZ 850160008 (Tel: 6029333124)

📍
Updated Practice Location May 04, 2023

Registered at 1919 E THOMAS RD, PHOENIX, AZ 850167710 (Tel: 6029331000)

📍
Updated Business Mailing Address May 04, 2023

Registered at 1706 S CEDAR AVE, BROKEN ARROW, OK 740126407 (Tel: 5862148344)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 09, 2021

Pediatrics (License #7329 in OK)

NPI Profile Active April 02, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location April 02, 2020

Registered at 4444 E 41ST ST, TULSA, OK 741352527 (Tel: 9186194400)

📍
Updated Business Mailing Address April 02, 2020

Registered at 4444 E 41ST ST, TULSA, OK 741352527 (Tel: 9186194400)

👤
Provider Name / Credentials Updated April 02, 2020

Recorded as JACK MANQUEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 02, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 30, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801424346
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 30, 2020
Last Update: July 01, 2025
Sole Proprietor: No

Mailing Address

1706 S Cedar Ave

Broken Arrow, OK 740126407

Phone: 5862148344

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.