MEDICARE: BRENT A BESON 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	2084N0400X	Neurology Physician	23752	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00735390	OTHER	OK	RAILROAD MEDICARE

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
2	P00722129	OTHER	OK	RAILROAD THRU NSO

General Provider Information

NPI Number	:	1538251632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENT A BESON MD

Provider Business Mailing Address
First Line	:	4221 S WESTERN
Second Line	:	SUITE 5000
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109
Country	:	US
Telephone Number	:	405-644-5160
Fax Number	:	405-644-5162

Provider Business Practice Location Address
First Line	:	4221 S WESTERN
Second Line	:	SUITE 5000
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109
Country	:	US
Telephone Number	:	405-644-5160
Fax Number	:	405-644-5162

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	10/24/2023

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Directions to “ BRENT A BESON MD” Practice Location

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