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General NPI Number Information
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NPI Number | 1659466449
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Entity Type | Individual
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Provider Name | BRADLEY J PHILLIPS MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 700 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5004
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Country | US
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Telephone | 405-271-5781
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Fax | 405-271-1643
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Provider Business Mailing Address
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Address Line | 7261 MERCY RD
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City | OMAHA
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State | NE
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Zip | 68124-2311
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Country | US
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Telephone | 402-398-6248
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Fax | 402-829-8513
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 4301080920
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 28613
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301080920
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 43351
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License Number State | OK
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