Organization
BRADLEY G CHRISTIANSON, DO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY GENE CHRISTIANSON D.O. (PRESIDENT)
(405) 701-3418
Entity
Organization
Contact information
Practice address
4800 S 109TH EAST AVE, TULSA, OK 74146-5822
(405) 701-3418
(405) 701-3451
Mailing address
PO BOX 21568, TULSA, OK 74121-1568
(405) 701-3418
(405) 701-3451
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3425
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100259270A
—
OK
Enumeration date
10/02/2006
Last updated
08/28/2008
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