MEDICARE: DR. BRIANNE C ROEPKE D.O.

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	207P00000X	Emergency Medicine Physician	6049	OK

General Provider Information

NPI Number	:	1730568965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIANNE C ROEPKE D.O.

Provider Business Mailing Address
First Line	:	744 W 9TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74127-9020
Country	:	US
Telephone Number	:	918-599-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 WEST 9TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74127-9028
Country	:	US
Telephone Number	:	918-599-1000
Fax Number	:

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

Provider Enumeration Date	:	05/20/2015
Last Update Date	:	06/27/2019

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