Individual
ELISE I BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3030 NW 149TH ST, OKLAHOMA CITY, OK 73134-1849
(405) 562-6222
(405) 562-6522
Mailing address
3030 NW 149TH ST, OKLAHOMA CITY, OK 73134-1849
(405) 562-6222
(405) 562-6522
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
28488
OK
Other
Enumeration date
05/25/2007
Last updated
06/03/2021
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