Individual
BRYAN VANNUEL MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13616 E 103RD STREET N, SUITE A, OWASSO, OK 74055
(918) 274-8555
(918) 274-8556
Mailing address
13616 E 103RD ST N, STE A, OWASSO, OK 74055-4586
(918) 274-8555
(918) 274-8556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19507
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253080A
—
OK
Enumeration date
02/06/2007
Last updated
12/20/2016
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