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Individual

ROBERT JOSEPH BRECKENRIDGE

Active
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Individual

ROBERT JOSEPH BRECKENRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
1794
OK
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
1794
OK
207R00000X
Internal Medicine Physician
Primary
1794
OK
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
1794
OK
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
1794
OK
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
37D2190466
OK
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
37D2190466
OK
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
1794
OK
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
1794
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100257360D
OK
01
110230825
RR MEDICARE
01
37D2190466
CLIA
OK
Enumeration date
04/06/2006
Last updated
07/19/2022
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