Individual
JEFFERSON MICHAEL JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 N PORTLAND AVE # 7, OKLAHOMA CITY, OK 73107-6120
(405) 945-6775
Mailing address
2025 CHURCHILL WAY, THE VILLAGE, OK 73120-1151
(405) 861-3610
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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