Healthcare Provider Details

I. General information

NPI: 1366536112
Provider Name (Legal Business Name): MERRILEE J OKEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 BOOKCLIFF AVE UNIT 104
GRAND JUNCTION CO
81501-8159
US

IV. Provider business mailing address

1190 BOOKCLIFF AVE UNIT 104
GRAND JUNCTION CO
81501-8159
US

V. Phone/Fax

Practice location:
  • Phone: 970-242-7060
  • Fax: 970-242-6198
Mailing address:
  • Phone: 970-242-7060
  • Fax: 970-242-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33102
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: