Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 5734 | OK |
N | 207YP0228X | Pediatric Otolaryngology | 82184 | SC |
NPI | 1790199560 |
---|---|
Provider Name | Jaye Bea Downs |
First Address | Tulsa, OK 74132-1823 |
Second Address | Tulsa, OK 74132-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 23/07/2020 |