Healthcare Provider Details

I. General information

NPI: 1225021702
Provider Name (Legal Business Name): BRIAN SNELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 PARKWAY COMMONS DR STE 100
OKLAHOMA CITY OK
73134-6036
US

IV. Provider business mailing address

14100 PARKWAY COMMONS DR STE 100
OKLAHOMA CITY OK
73134-6036
US

V. Phone/Fax

Practice location:
  • Phone: 405-748-3300
  • Fax: 405-749-1671
Mailing address:
  • Phone: 405-748-3300
  • Fax: 405-749-1671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberM2119
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number21270
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: