Most Relevant Information
Provider Data
| NPI Number: | 1003430869 |
| Provider Name: | JEFFERIES BLAKE DAVIS |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/07/2020 |
| Last Updated: | 06/08/2020 |
Provider Practice Location
10700 S CHOCTAW RD
NEWALLA
OK
748577962
Practice Location Phone/Fax
| Phone: | 4057427713 |
| Fax: |
Provider Mailing Location
7701 S ANDERSON RD
OKLAHOMA CITY
OK
731506708
Provider Mailing Phone/Fax
| Phone: | 4057427713 |
| Fax: |