Individual
BRADLEY CLIFFORD TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14701 N SANTA FE AVE, EDMOND, OK 73013-3411
(405) 752-2733
(405) 752-2172
Mailing address
14701 N SANTA FE AVE, EDMOND, OK 73013-3411
(405) 752-2733
(405) 752-2172
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2479
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100153730A
—
OK
01
—
2871904
CIGNA
OK
01
—
458329
AETNA
OK
01
—
899616
UNITED HEALTHCARE
OK
Enumeration date
05/26/2005
Last updated
05/08/2008
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