Healthcare Provider Details

I. General information

NPI: 1265671093
Provider Name (Legal Business Name): BRENT ALAN DRESSLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 S 109TH EAST AVE
TULSA OK
74146-5822
US

IV. Provider business mailing address

4802 S 109TH EAST AVE
TULSA OK
74146-5822
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-1400
  • Fax: 918-392-1488
Mailing address:
  • Phone: 918-392-1400
  • Fax: 918-392-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101017993
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOS016330
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberQ1396
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number6087
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: