Individual
DR. BRYCE OWEN BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 223-5400
Mailing address
1600 SCRIPTURE ST, DENTON, TX 76201-3809
(940) 384-6000
(940) 382-7680
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
30974
AZ
207ZD0900X
Dermatopathology (Pathology) Physician
7103
OK
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
30974
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
7103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098530A
—
OK
01
—
751465559002
BCBS
—
Enumeration date
08/31/2006
Last updated
01/11/2012
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