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General NPI Number Information
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NPI Number | 1134178411
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Entity Type | Individual
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Provider Name | BRADLEY CHRISTIANSON DO
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Gender | Male
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Dates
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Enumeration Date | 05/06/2006
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 4800 S 109TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74146-5822
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Country | US
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Telephone | 918-742-2502
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 S 109TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74146-5822
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 3425
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 3425
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License Number State | OK
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