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NPI Code Detail

MEDICARE: BRYAN ANDREW FEHR

MEDICARE: BRYAN ANDREW FEHR
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1184944225
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN ANDREW FEHR
Provider Business Mailing Address
First Line : 4913 W RENO AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73127-6339
Country : US
Telephone Number : 405-948-4900
Fax Number : 405-948-4933
Provider Business Practice Location Address
First Line : 5208 W RENO AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73127-6344
Country : US
Telephone Number : 405-948-4900
Fax Number : 405-948-4933
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2010
Last Update Date : 12/22/2023

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