Organization
BRADLEY BIBB MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONYA YORK (CONTROLLER)
(870) 856-1202
Entity
Organization
Contact information
Practice address
1201 E HARTFORD AVE, PONCA CITY, OK 74601-2018
(580) 762-1911
(580) 762-0887
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2024
Last updated
10/02/2024
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