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General NPI Number Information
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NPI Number | 1487638094
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Entity Type | Individual
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Provider Name | JAY L BRYNGELSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 222 SE DEBELL
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City | BARTLESVILLE
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State | OK
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Zip | 74006
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Country | US
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Telephone | 918-333-3432
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Fax | 918-333-5937
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Provider Business Mailing Address
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Address Line | 226 SE DEBELL BLDG A
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City | BARTLESVILLE
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State | OK
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Zip | 74006
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Country | US
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Telephone | 918-333-3432
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Fax | 918-333-5937
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 10935
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License Number State | OK
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