Individual
JEREMY BRANDON MOAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
105 S BRYANT AVE STE 104, EDMOND, OK 73034
(405) 715-2022
(405) 715-2905
Mailing address
105 S BRYANT AVE STE 104, EDMOND, OK 73034-6361
(405) 715-2022
(405) 715-2905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25707
OK
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25707
OK
207RP1001X
Pulmonary Disease Physician
Primary
25707
OK
Other
Enumeration date
06/22/2007
Last updated
07/27/2023
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