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Individual

DR. STEPHEN DON BRUNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1725 E 19TH ST, SUITE 800, TULSA, OK 74104-5472
(918) 301-2505
(918) 301-3636
Mailing address
1725 E 19TH ST, SUITE 800, TULSA, OK 74104-5472
(918) 301-2505
(918) 301-3636

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20793
OK
2086S0127X
Trauma Surgery Physician
20793
OK
2086S0129X
Vascular Surgery Physician
20793
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020051983
RAILROAD MEDICARE
OK
05
100132070A
OK
Enumeration date
07/05/2006
Last updated
03/10/2010
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