Provider Demographics
NPI:1427247154
Name:DR. STEVEN JIMERSON, M.D., INC.
Entity type:Organization
Organization Name:DR. STEVEN JIMERSON, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:JIMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-360-2809
Mailing Address - Street 1:1407 N PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6659
Mailing Address - Country:US
Mailing Address - Phone:405-360-2809
Mailing Address - Fax:405-364-3480
Practice Address - Street 1:1407 N PORTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6659
Practice Address - Country:US
Practice Address - Phone:405-360-2809
Practice Address - Fax:405-364-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9690174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK900522099Medicare PIN