Provider Demographics
NPI:1740428549
Name:JEFFERY R. OKA, M.D., P.C.
Entity type:Organization
Organization Name:JEFFERY R. OKA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NERIZA
Authorized Official - Middle Name:T
Authorized Official - Last Name:OKA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-390-4216
Mailing Address - Street 1:425 MEDICAL DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4945
Mailing Address - Country:US
Mailing Address - Phone:801-292-2500
Mailing Address - Fax:801-292-2423
Practice Address - Street 1:425 MEDICAL DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4945
Practice Address - Country:US
Practice Address - Phone:801-292-2500
Practice Address - Fax:801-292-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT871774451205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty