Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 30628 | OK |
NPI | 1164716874 |
---|---|
Provider Name | Dr. Jonathan David Meyer |
First Address | Oklahoma City, OK 73104-4637 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2011 |
Last Update Date | 03/07/2014 |