Healthcare Provider Details

I. General information

NPI: 1497862338
Provider Name (Legal Business Name): BRIAN K HARRISON DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/15/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WEST MAIN
CARNEGIE OK
73015
US

IV. Provider business mailing address

8 BRIAN ST
CARNEGIE OK
73015-6100
US

V. Phone/Fax

Practice location:
  • Phone: 580-654-1111
  • Fax: 580-654-1229
Mailing address:
  • Phone: 580-654-2246
  • Fax: 580-654-1229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11093
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: