Provider Demographics
NPI:1780651679
Name:LHOMMEDIEU, JEFFREY W (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:W
Last Name:LHOMMEDIEU
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5701 SE 74TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-1106
Mailing Address - Country:US
Mailing Address - Phone:405-600-6869
Mailing Address - Fax:405-600-6978
Practice Address - Street 1:3400 W TECUMSEH RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-307-6900
Practice Address - Fax:405-307-6906
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2015-02-17
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Provider Licenses
StateLicense IDTaxonomies
OK19872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32087Medicare UPIN
OK245602601Medicare PIN