Healthcare Provider Details

I. General information

NPI: 1518059765
Provider Name (Legal Business Name): PER OKEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W. FRANKLIN STREET
CLINTON MI
49236
US

IV. Provider business mailing address

2100 COMMONWEALTH SUITE 202
ANN ARBOR MI
48105
US

V. Phone/Fax

Practice location:
  • Phone: 517-456-7449
  • Fax: 517-456-6059
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301038351
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: