Provider Demographics
NPI:1366536112
Name:OKEY, MERRILEE J (DO)
Entity type:Individual
Prefix:
First Name:MERRILEE
Middle Name:J
Last Name:OKEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1190 BOOKCLIFF AVE UNIT 104
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8159
Mailing Address - Country:US
Mailing Address - Phone:970-242-7060
Mailing Address - Fax:970-242-6198
Practice Address - Street 1:1190 BOOKCLIFF AVE UNIT 104
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8159
Practice Address - Country:US
Practice Address - Phone:970-242-7060
Practice Address - Fax:970-242-6198
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO33102208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01331024Medicaid
CO01331024Medicaid