Healthcare Provider Details

I. General information

NPI: 1780693309
Provider Name (Legal Business Name): JOE C ZUERKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 MCAULEY BLVD SUITE 375
OKLAHOMA CITY OK
73120-9391
US

IV. Provider business mailing address

4205 MCAULEY BLVD SUITE 375
OKLAHOMA CITY OK
73120-9391
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-4247
  • Fax: 405-749-4249
Mailing address:
  • Phone: 405-749-4247
  • Fax: 405-749-4249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number13829
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: