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General NPI Number Information
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NPI Number | 1770917353
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Entity Type | Organization
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Legal Business Name | PHILIP C BRYAN MD PLLC
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Dates
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Enumeration Date | 08/30/2013
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1000 N LEE AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-1036
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Country | US
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Telephone | 405-272-4200
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Fax | 405-272-4203
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Provider Business Mailing Address
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Address Line | 1515 TOWER DR
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City | MOORE
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State | OK
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Zip | 73160-6181
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Country | US
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Telephone | 405-310-0836
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Fax | 405-758-5582
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP C BRYAN
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Credential | MD
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Telephone | 405-919-4924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 9273
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License Number State | OK
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