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Individual

DR. DOUGLAS WAYNE BRANT SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6801 NW 39TH EXPY, BETHANY, OK 73008-2501
(405) 789-2441
(405) 789-7978
Mailing address
6801 NW 39TH EXPRESSWAY, DEACONESS FAMILY CARE BETHANY, BETHANY, OK 73008-2501
(405) 789-2441
(405) 789-7978

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9222
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080175208
MEDICARE RR
OK
05
100110280A
OK
Enumeration date
07/10/2006
Last updated
05/01/2012
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