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NPI Code Detail

MEDICARE: DR. ALLAN BENJAMIN JEFFY DPH

MEDICARE: DR. ALLAN BENJAMIN JEFFY DPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist7791OK

General Provider Information

NPI Number : 1609868660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLAN BENJAMIN JEFFY DPH
Provider Business Mailing Address
First Line : 6810 E 95TH ST
Second Line :
City : TULSA
State : OK
Zip : 74133-5363
Country : US
Telephone Number : 918-494-3080
Fax Number :
Provider Business Practice Location Address
First Line : 1007 S PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-4495
Country : US
Telephone Number : 918-587-1101
Fax Number : 918-858-0059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 07/08/2007

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