Organization
BRYANT STREET FAMILY MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHESCA NICOLE CRAIG-GOODELL D.O. (PHYSICIAN)
(405) 513-7333
Entity
Organization
Contact information
Practice address
305 SOUTH BRYANT AVE, 110, EDMOND, OK 73034
(405) 513-7333
(405) 513-7337
Mailing address
305 SOUTH BRYANT AVE, 110, EDMOND, OK 73034
(405) 513-7333
(405) 513-7337
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366510802
INDIVIDUAL PROVIDER NPI NUMBER
OK
Enumeration date
07/17/2008
Last updated
11/01/2016
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