Individual
DR. EVAN LEE BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1010 WEST 3RD ST, SULPHUR, OK 73086-0499
(580) 622-2020
(580) 622-3213
Mailing address
PO BOX 499, SULPHUR, OK 73086-0499
(580) 622-2020
(580) 622-3213
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1100
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100765070A
—
OK
Enumeration date
12/13/2006
Last updated
06/14/2012
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