Individual
ROBERT JOSEPH BRECKENRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
401 E OKLAHOMA AVE, ENID, OK 73701-5800
(580) 233-4300
(580) 350-6401
Mailing address
401 E OKLAHOMA AVE, ENID, OK 73701-5800
(580) 233-4300
(580) 350-6401
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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