Healthcare Provider Details

I. General information

NPI: 1942495080
Provider Name (Legal Business Name): JAMES MICHAEL FERRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 S MICKEY MANTLE DR SUITE 325
OKLAHOMA CITY OK
73104-2458
US

IV. Provider business mailing address

7 S MICKEY MANTLE DR SUITE 325
OKLAHOMA CITY OK
73104-2458
US

V. Phone/Fax

Practice location:
  • Phone: 405-232-0101
  • Fax: 405-232-0102
Mailing address:
  • Phone: 405-232-0101
  • Fax: 405-232-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27427
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: