Individual
BRIAN THOMAS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 E ROBINSON ST, STE 2600, NORMAN, OK 73071-6697
(405) 364-6432
(405) 364-0090
Mailing address
500 E ROBINSON ST, STE 2600, NORMAN, OK 73071-6697
(405) 364-6432
(405) 364-0090
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26325
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200244680A
—
OK
Enumeration date
06/09/2008
Last updated
12/06/2012
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