MEDICARE: DR. TERRY M NAYFA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	147	OK

General Provider Information

NPI Number	:	1003809583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY M NAYFA DPM

Provider Business Mailing Address
First Line	:	3612 NW 50TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5642
Country	:	US
Telephone Number	:	405-947-5492
Fax Number	:	405-947-5532

Provider Business Practice Location Address
First Line	:	3612 NW 50TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5642
Country	:	US
Telephone Number	:	405-947-5492
Fax Number	:	405-947-5532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	07/09/2007

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