Provider Demographics
NPI:1750578332
Name:PERDUE, JEDIDIAH J (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JEDIDIAH
Middle Name:J
Last Name:PERDUE
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:405-657-3704
Mailing Address - Fax:405-657-3892
Practice Address - Street 1:4509 INTEGRIS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8696
Practice Address - Country:US
Practice Address - Phone:405-657-3704
Practice Address - Fax:405-657-3892
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2023-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK262782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200521480AMedicaid
331689YPLMMedicare PIN