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General NPI Number Information
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NPI Number | 1184435380
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Entity Type | Organization
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Legal Business Name | SPIRE MEDICAL CONSULTING
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 11325 WINDING LAKE DR
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City | ARCADIA
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State | OK
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Zip | 73007-9715
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Country | US
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Telephone | 405-938-5859
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 537
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City | ARCADIA
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State | OK
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Zip | 73007-0537
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Country | US
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Telephone | 405-938-5859
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. BRENDON DEAN MCCOLLOM
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Credential | DO
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Telephone | 405-938-5859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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