Individual
BRIAN R BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4200 W MEMORIAL RD, SUITE 610, OKLAHOMA CITY, OK 73120-9350
(405) 749-7023
(405) 749-7024
Mailing address
4401 W MEMORIAL RD, 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
13955
OK
2086X0206X
Surgical Oncology Physician
Primary
13955
OK
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
13955
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100124430A
—
OK
Enumeration date
02/21/2006
Last updated
04/20/2016
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