Organization
JEFFREY G BERRY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY G BERRY MD (PRESIDENT)
(405) 524-4105
Entity
Organization
Contact information
Practice address
1111 N LEE AVE, SUITE 236, OKLAHOMA CITY, OK 73103-2600
(405) 524-4105
(405) 235-0738
Mailing address
PO BOX 5366, EDMOND, OK 73083-5366
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200127640A
—
OK
01
—
612969700
US DEPT OF LABOR
OK
01
—
DN8773
RR MEDICARE
OK
Enumeration date
11/27/2007
Last updated
09/01/2009
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