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General NPI Number Information
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NPI Number | 1134336373
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Entity Type | Individual
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Provider Name | BRADLEY RUSSELL MONS D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 411 STONE WOOD DR
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1026
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Country | US
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Telephone | 918-924-6275
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Fax | 918-518-7563
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Provider Business Mailing Address
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Address Line | 411 STONE WOOD DR
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1026
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Country | US
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Telephone | 918-922-2368
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Fax | 918-922-2367
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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 | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 57565
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 57565
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 5413
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | OS014959
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License Number State | PA
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