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NPI Code Detail

MEDICARE: BRADLEY CADE MCNEESE

MEDICARE:   BRADLEY CADE MCNEESE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1477336584
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY CADE MCNEESE
Provider Business Mailing Address
First Line : 10629 S 91ST EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74133-7044
Country : US
Telephone Number : 918-995-0652
Fax Number :
Provider Business Practice Location Address
First Line : 10629 S 91ST EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74133-7044
Country : US
Telephone Number : 918-995-0652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ BRADLEY CADE MCNEESE ” Practice Location

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