JEREMY BRANDON MOAD


Address: 105 S Bryant Ave Ste 104, Edmond, OK 73034
Phone: 4057152022

JEREMY BRANDON MOAD (NPI# 1134325608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134325608
Entity Type Individual
Full Name JEREMY BRANDON MOAD
Credential M.D
Practice Address 105 S Bryant Ave Ste 104
Edmond
OK 73034
Mailing Address 105 S Bryant Ave Ste 104
Edmond
OK 73034-6361
Practice Telephone 4057152022
Practice Fax Number 4057152905
Mailing Telephone 4057152022
Mailing Fax Number 4057152905
Enumeration Date 2007-06-22
Last Update Date 2019-05-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 25707 OK Allopathic & Osteopathic Physicians
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
25707 OK Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
6161 S Yale Ave, Tulsa, OK 741361902 9185021900

Office Location

Street Address 105 S BRYANT AVE STE 104
City EDMOND
State OK
Zip Code 73034

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033362231 Edmond Podiatry Associates LLC Clinic/Center 105 S Bryant Ave Ste 104, Edmond, OK 73034-6361 2008-10-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306447172 Saints Medical Group, LLC Family Medicine 2749 Progressive Dr, Suite B, Edmond, OK 73034 2020-11-06
1194339861 Susan Haesook Kim Pharmacist 1400 2nd St, Edmod, Edmond, OK 73034 2020-09-01
1821616038 Aaron Michael Gowens Specialist/Technologist 015 Wantland Hall 100 University Dr., Edmond, OK 73034 2020-07-14
1043834849 Paddington Place Lcc Intermediate Care Facility, Mental Illness 3225 French Park Drive, Suite 6, Edmond, OK 73034 2020-06-08
1083254932 Purpose Healthcare Inc Psychologist 301 South Blvd, Suite 117, Edmond, OK 73034 2020-01-08
1740773662 Healthcare Express, LLP Family Medicine 2300 E 2nd St, Edmond, OK 73034 2018-06-14
1427555713 Sara Nicole Smith Specialist/Technologist 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 2018-04-12
1619475084 Carissa Leigh Brackelsberg Chiropractor 3709 E 2nd St, Edmond, OK 73034 2018-01-31
1760996177 Laurel Michelle Glendening Physical Therapist 3531 River Wood Lane, Edmond, OK 73034 2017-11-21
1134643380 Keith S Quinn Dentist 3008 Peaceful Ln, Edmond, OK 73034 2017-07-31
Find all providers in zip 73034

Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164688255 Sleep Practice Management LLC Internal Medicine 305 N Bryant Ave, Edmond, OK 73034-6276 2008-07-29
1871579185 Elliott R Schwartz Internal Medicine 809 Glenridge Dr, Edmond, OK 73013-1826 2005-12-19
1982774428 Jeremy Cole Md Pllc Internal Medicine 105 S Bryant Ave, Suite 204b, Edmond, OK 73034-6399 2006-11-09
1962586701 Jeremy Cole Internal Medicine 105 S Bryant Ave, Suite 204b, Edmond, OK 73034-6399 2006-10-25

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1124598149 Pulmonary Care Innovations Pllc Internal Medicine 2832 E 101st St, Tulsa, OK 74137-5601 2018-12-03
1184145393 A&r Management Services, Inc. Internal Medicine 2621 E 38th St, Tulsa, OK 74105-8206 2017-06-28
1417319096 Abed Madanieh Internal Medicine 800 Stanton L Young Blvd # 8400, Oklahoma City, OK 73104-5018 2016-03-23
1689966103 Anthony Xavier Troitino Internal Medicine 3366 Nw Expressway Ste 650, Oklahoma City, OK 73112-4490 2011-05-03
1164654117 Viral K Doshi Internal Medicine 13313 N Meridian Ave Ste D, Oklahoma City, OK 73120-8316 2009-08-10
1538393384 Richard Waldo Nicholson Internal Medicine Rr 1 Box 1799, Checotah, OK 74426-9794 2009-05-07
1821219098 Robert Keith Wilson Internal Medicine 2753 S. Utica Ave, Tulsa, OK 74114 2007-05-02
1023239431 Wachita Kidney and Hypertension Specialists Pllc Internal Medicine 4417 W Gore Blvd Ste 3, Lawton, OK 73505-5978 2007-05-01
1518007632 Saif Ullah Farooq Internal Medicine 4221 S Western Ave Ste 4005, Oklahoma City, OK 73109-3436 2007-02-07
1427136381 Pulmonary & Sleep Medicine Assoc PC Internal Medicine 2801 Parklawn Dr Ste 301, Midwest City, OK 73110-4230 2006-11-01
Find all providers with the same taxonomy

Competitor

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City EDMOND
Zip Code 73034

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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