Individual
GREGORY Y JIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4200 S DOUGLAS AVE STE 200, OKLAHOMA CITY, OK 73109-3215
(405) 636-7499
(405) 636-7809
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 636-7499
(405) 636-7809
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
12/20/2005
Last updated
01/11/2021
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