Individual
JAMES DAVID BRIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADC
Contact information
Practice address
2617 GENERAL PERSHING BLVD, OKLAHOMA CITY, OK 73107-6437
(405) 858-1700
Mailing address
PO BOX 12978, OKLAHOMA CITY, OK 73157-2978
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015
COUNSELOR
—
Enumeration date
01/10/2014
Last updated
06/05/2019
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