Individual
BRUCE D PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 S MADISON ST, SUITE 202, ENID, OK 73701-7273
(580) 616-7605
(580) 616-7626
Mailing address
PO BOX 960394, OKLAHOMA CITY, OK 73196-0001
(580) 548-1367
(580) 548-1583
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
13141
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100824270B
—
OK
Enumeration date
08/09/2006
Last updated
11/24/2010
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