Individual
JEFFREY G BERRY
Active
Individual
JEFFREY G BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19893
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100047890A
—
OK
01
—
P00643961
RR MEDICARE
OK
Enumeration date
12/02/2005
Last updated
10/06/2009
Update your record
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