Individual
REAGAN H BRADFORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
608 STANTON L YOUNG BLVD, OKLAHOMA CITY, OK 73104-5014
(405) 271-1092
(405) 271-7821
Mailing address
608 STANTON L YOUNG BLVD, OKLAHOMA CITY, OK 73104-5014
(405) 271-1092
(405) 271-7821
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
13090
OK
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
13090
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100095840C
—
OK
Enumeration date
03/20/2006
Last updated
08/04/2020
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