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Individual

LAURA BILBRUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
800 W BOISE CIR, SUITE 160, BROKEN ARROW, OK 74012-4906
(918) 994-9160
(918) 293-3169
Mailing address
1515 N HARVARD AVE, SUITE E, TULSA, OK 74115-4957
(918) 832-6049
(918) 832-6055

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20265
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100229790A
OK
Enumeration date
03/14/2006
Last updated
09/28/2011
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