Individual
JEFFREY LEE DAKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(573) 778-4559
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(573) 778-4559
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD071201L
PA
207RC0001X
Clinical Cardiac Electrophysiology Physician
220681-1
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
35-082276
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD071201L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001799454
—
PA
05
—
02079225
—
NY
05
—
2189760
—
OH
Enumeration date
05/24/2005
Last updated
04/15/2020
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