BETHANY MEDICAL CLINIC, PLLC (NPI# 1255522306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255522306 |
| Entity Type | Organization |
| Organization Name | BETHANY MEDICAL CLINIC, PLLC |
| Practice Address |
6801 Nw 39th Expy Bethany OK 73008-2501 |
| Practice Telephone | 4057892441 |
| Mailing Telephone | 4057892441 |
| Mailing Fax Number | 4057897978 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | DR. DOUGLAS W. BRANT (OWNER) |
| Authorized Official Telephone | 4057892441 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
9222 | OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | MEDICARE RR GROUP | CH9820 | 01 |
| Street Address |
6801 NW 39TH EXPY |
| City | BETHANY |
| State | OK |
| Zip Code | 73008-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275567695 | Lyn Glezen Brant | Nurse Practitioner | 6801 Nw 39th Expy, Bethany, OK 73008-2501 | 2006-07-10 |
| 1225570013 | Olson Dental Group, Pllc | Dentist | 6801 Nw 39th Expy, Suite A, Bethany, OK 73008-2501 | 2016-11-09 |
| 1174806822 | Velda Journey | Pharmacist | 6801 Nw 39th Expy, Bethany, OK 73008-2501 | 2011-09-20 |
| 1457568388 | Jennifferr Louise Baird | Registered Nurse | 6801 Nw 39th Expy, Bethany, OK 73008-2501 | 2007-05-17 |
| 1083770358 | Dons Pharmacy Limited | Pharmacy | 6801 Nw 39th Expy, Bethany, OK 73008-2599 | 2006-12-29 |
| 1780618108 | Douglas Wayne Brant Sr. | Family Medicine | 6801 Nw 39th Expy, Bethany, OK 73008-2501 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780150151 | Kimberly Campbell | Counselor | 6612 Nw 42nd Street, Bethany, OK 73008 | 2018-10-23 |
| 1366943151 | Arkansas Liver and Gastroenterology, Pa | Clinic/Center | 2347 North Thompkins Ave, Bethany, OK 73008 | 2018-02-27 |
| 1881106805 | Tiffany Harmon | Physical Therapy Assistant | 6729 Nw 39th Exp., Sawyer Center, Bethany, OK 73008 | 2017-10-31 |
| 1740660257 | Michael Brobston | Specialist | 6729 Nw 39th Expressway, Bethany, OK 73008 | 2015-06-01 |
| 1043626120 | Danielle Manning | Case Manager/Care Coordinator | 6729 Nw Expressway, Bethany, OK 73008 | 2014-07-09 |
| 1487065157 | Carolyn Mgcdf Jones | Behavioral Analyst | 2209 Nth. Beaver Ave., Bethany, OK 73008 | 2014-05-15 |
| 1013327022 | Ephraim Kelley | Counselor | 2800 N. Rockwell Ave., Bethany, OK 73008 | 2014-04-29 |
| 1356600407 | Mallory Crosier | Occupational Therapist | 6800 Nw 39th Expresswaay, Bethany, OK 73008 | 2012-05-10 |
| 1326310897 | Isaac I Juarez | Psychologist | 2020 N Briarcliff Ave., Bethany, OK 73008 | 2012-01-31 |
| 1295015295 | Lauren Vanderloo | Counselor | 7908 Northwest 23rd St, Bethany, OK 73008 | 2011-08-22 |
| Find all providers in zip 73008 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1922313972 | Clear Focus Cv Ultrasound Services | Clinic/Center | 502 Oak, Ardmore, OK 73401-3830 | 2010-08-15 |
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| 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.