Organization
D BRENT TIPTON M D INC
Active
Organization
D BRENT TIPTON M D INC
Active
Other names
DBA D BRENT TIPTON M D INC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOY A. COSTNER (ACCOUNTS MANAGER)
(405) 329-2390
Entity
Organization
Contact information
Practice address
5100 N BROOKLINE AVE, SUITE 530, OKLAHOMA CITY, OK 73112-3623
(405) 604-6652
(405) 604-6653
Mailing address
PO BOX 973, NORMAN, OK 73070-0973
(405) 329-2390
(405) 329-0486
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
18762
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100112170A
—
OK
01
—
44456086901
BC/BS
OK
Enumeration date
08/04/2006
Last updated
11/02/2016
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