Individual
DR. JERRY D RENFROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3435 NW 56, #711A, OKLAHOMA CITY, OK 73112
(405) 945-4222
(405) 945-4322
Mailing address
3435 NW 56, #711A, OKLAHOMA CITY, OK 73112
(405) 945-4222
(405) 945-4322
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
8729
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040004091
RR MEDICARE
—
05
—
100187980A
—
OK
Enumeration date
09/25/2006
Last updated
05/03/2026
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