MEDICARE: PHILIP CLAY BRYAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	9273	OK
2	208600000X	Surgery Physician	9273	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104828359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP CLAY BRYAN MD

Provider Business Mailing Address
First Line	:	1515 TOWER DR
Second Line	:
City	:	MOORE
State	:	OK
Zip	:	73160-6181
Country	:	US
Telephone Number	:	405-310-0836
Fax Number	:	405-758-5582

Provider Business Practice Location Address
First Line	:	1000 N LEE AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1036
Country	:	US
Telephone Number	:	405-340-2346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/28/2025

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Directions to “ PHILIP CLAY BRYAN MD” Practice Location

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