Healthcare Provider Details

I. General information

NPI: 1376684167
Provider Name (Legal Business Name): BRANDON SCOTT CLAFLIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9308 S TOLEDO AVE
TULSA OK
74137-2739
US

IV. Provider business mailing address

9308 S TOLEDO AVE
TULSA OK
74137-2739
US

V. Phone/Fax

Practice location:
  • Phone: 918-728-8020
  • Fax: 918-728-8019
Mailing address:
  • Phone: 918-728-8020
  • Fax: 918-728-8019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberM7119
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number4854
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: