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General NPI Number Information
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NPI Number | 1073772398
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Entity Type | Individual
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Provider Name | BRIAN KEITH FIRESTONE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 608 STANTON L YOUNG BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5014
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Country | US
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Telephone | 405-271-6060
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Fax | 405-271-7873
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Provider Business Mailing Address
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Address Line | 3037 NW 63RD ST STE W251
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3637
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Country | US
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Telephone | 405-691-0505
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Fax | 405-691-0507
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD445114
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 30196
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License Number State | OK
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