Individual
DR. BRIAN A. BOATWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8110 S YALE AVE, TULSA, OK 74137-2210
(918) 794-2003
(918) 794-2010
Mailing address
8110 S YALE AVE, TULSA, OK 74137-2210
(918) 794-2003
(918) 794-2010
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1144
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295091411
MEDICARE GROUP NPI
—
05
—
200463840A
—
OK
Enumeration date
08/17/2011
Last updated
04/26/2013
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