Individual
BRAD F WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3906 S PEORIA AVE, TULSA, OK 74105-3131
(918) 585-1523
(918) 584-5520
Mailing address
3906 S PEORIA AVE, TULSA, OK 74105-3131
(918) 585-1523
(918) 584-5520
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2437
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200038340A
—
OK
01
—
P00178439
RAIL ROAD MEDICARE
OK
Enumeration date
05/31/2006
Last updated
07/26/2011
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