| Jeri Ellis Md Mph Pc | |
|
5835 S Pennsylvania Ave Oklahoma City OK 73119-7001 | |
| (405) 816-3311 | |
| (405) 634-7577 |
| Full Name | Jeri Ellis Md Mph Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 5835 S Pennsylvania Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Jeri Ellis (OWNER) |
| Authorized Official Contact | 4056049595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeri Ellis Md Mph Pc 5835 S Pennsylvania Ave Oklahoma City OK 73119-7001 Ph: (405) 816-3311 | Jeri Ellis Md Mph Pc 5835 S Pennsylvania Ave Oklahoma City OK 73119-7001 Ph: (405) 816-3311 |
| NPI Number | 1043361934 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 05/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043361934 | NPI | - | NPPES |
| 569535528001 | Other | OK | BCBS |
| 200049610A | Medicaid | OK | |
| 200075590B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20048 (Oklahoma) | Primary |
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