MEDICARE: ANDREW R BRIGGEMAN, DO, LLC

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
1	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	4055	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720234891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW R BRIGGEMAN, DO, LLC

Provider Business Mailing Address
First Line	:	6825 S DELAWARE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-4502
Country	:	US
Telephone Number	:	918-994-4810
Fax Number	:	918-994-4816

Provider Business Practice Location Address
First Line	:	6825 S DELAWARE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-4502
Country	:	US
Telephone Number	:	918-994-4810
Fax Number	:	918-994-4816

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ANDREW R BRIGGEMAN
Credential	:	D.O.
Telephone Number	:	918-994-4810

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	07/21/2022

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