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General NPI Number Information
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NPI Number | 1740428549
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Entity Type | Organization
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Legal Business Name | JEFFERY R. OKA, M.D., P.C.
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 425 MEDICAL DR SUITE 108
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4945
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Country | US
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Telephone | 801-292-2500
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Fax | 801-292-2423
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Provider Business Mailing Address
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Address Line | 425 MEDICAL DR SUITE 108
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4945
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Country | US
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Telephone | 801-292-2500
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Fax | 801-292-2423
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Authorized Official
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Title or Position | BILLER/OFFICE MANAGER
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Name | MRS. NERIZA T OKA
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Credential | R.N.
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Telephone | 801-390-4216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 871774451205
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License Number State | UT
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