Individual
RANDALL WATSON BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 2ND AVE SW, MIAMI, OK 74354-6830
(918) 542-6611
(918) 787-3635
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(918) 542-6611
(918) 787-3635
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0033098
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100786990A
—
OK
05
—
200468380N
—
OK
05
—
500156500
—
MO
05
—
911329803
—
MO
Enumeration date
03/16/2006
Last updated
04/05/2017
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