MEDICARE: JULIANA CAMILLE BRYANT 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	207W00000X	Ophthalmology Physician	38289	OK

General Provider Information

NPI Number	:	1225659576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA CAMILLE BRYANT MD

Provider Business Mailing Address
First Line	:	800 STANTON L YOUNG BLVD # 6300
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5018
Country	:	US
Telephone Number	:	405-271-5963
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 NW 21ST ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73107-3201
Country	:	US
Telephone Number	:	918-232-3131
Fax Number	:

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

Provider Enumeration Date	:	04/28/2020
Last Update Date	:	09/23/2024

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