Provider Demographics
NPI:1689748501
Name:NUVEEN, ERIK JON (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JON
Last Name:NUVEEN
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-5111
Mailing Address - Country:US
Mailing Address - Phone:405-842-6677
Mailing Address - Fax:405-842-6678
Practice Address - Street 1:2100 NW 63RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-5111
Practice Address - Country:US
Practice Address - Phone:405-842-6677
Practice Address - Fax:405-842-6678
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23411208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery