Individual
JEFFRY MICHAEL BRYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1701 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-6221
(405) 302-8999
(405) 733-9360
Mailing address
PO BOX 113, WANETTE, OK 74878-0113
(405) 694-6950
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
699
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100113870A
—
OK
Enumeration date
03/20/2006
Last updated
04/05/2024
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