Organization
GREGORY Y JIA MD INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY X JIA (OFFICE MANAGER)
(580) 256-7377
Entity
Organization
Contact information
Practice address
908 19TH ST, SUITE 300, WOODWARD, OK 73801-2307
(580) 256-7377
(580) 256-7767
Mailing address
908 19TH ST, SUITE 300, WOODWARD, OK 73801-2307
(580) 256-7377
(580) 256-7767
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
19082
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138540A
—
OK
Enumeration date
02/08/2007
Last updated
10/21/2020
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