Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 147 | OK |
Y | 222Z00000X | Podiatrist | 147 | OK |
NPI | 1003809583 |
---|---|
Provider Name | Dr. Terry M Nayfa |
First Address | Oklahoma City, OK 73112-5642 |
Second Address | Oklahoma City, OK 73112-5642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T40770 | (02) |