Healthcare Provider Details

I. General information

NPI: 1073957049
Provider Name (Legal Business Name): BRANDON SCOTT DRABEK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PRESTON PARK DR
YUKON OK
73099-2152
US

IV. Provider business mailing address

900 PRESTON PARK DR
YUKON OK
73099-2152
US

V. Phone/Fax

Practice location:
  • Phone: 405-640-9684
  • Fax:
Mailing address:
  • Phone: 405-640-9684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number5554
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5554
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: