JERRY BRAZIEL (NPI# 1528462603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528462603 |
| Entity Type | Individual |
| Full Name | JERRY BRAZIEL |
| Credential | P.A.-C |
| Practice Address |
519 E State Rd Fairview OK 73737-1458 |
| Mailing Address |
714 Ninnekah St Enid OK 73701-5201 |
| Practice Telephone | 5802272585 |
| Mailing Telephone | 5806031762 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2019-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2442 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200574140A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 915 E Owen K Garriott Rd Ste J, Enid, OK 73701 | 5802975157 | 5802975167 |
| 908 N Rockford Rd, Ardmore, OK 73401 | 5802267771 |
| Street Address |
519 E STATE RD |
| City | FAIRVIEW |
| State | OK |
| Zip Code | 73737-1458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588666010 | Solomon Ali | General Practice | 519 E State Rd, Fairview, OK 73737-1458 | 2005-08-15 |
| 1285037416 | Fairview Regional Medical Center | Clinic/Center | 519 E State Rd, Fairview, OK 73737-1458 | 2014-10-02 |
| 1114105640 | Andrea Ellen Mceachern | Family Medicine | 519 E State Rd, Fairview, OK 73737-1458 | 2008-02-06 |
| 1356379309 | Fairview Regional Medical Center Authority | Family Medicine | 519 E State Rd, Fairview, OK 73737-1458 | 2006-06-29 |
| 1437185667 | Donald Klinger | Family Medicine | 519 E State Rd, Fairview, OK 73737-1458 | 2006-06-22 |
| 1316981657 | Fairview Regional Medical Center Authority | Family Medicine | 519 E State Rd, Fairview, OK 73737-1458 | 2006-06-16 |
| 1508868050 | John P. Harris | General Practice | 519 E State Rd, Fairview, OK 73737-1458 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598212664 | Megan Leigh Ewing | Nurse Practitioner | 519 East State Road, Fairview, OK 73737 | 2016-09-07 |
| 1144507492 | Oliver Gary Lackey | Pharmacist | 624 N Main St, Fairview, OK 73737 | 2011-11-14 |
| 1720298524 | Mary Kliewer | Counselor | 1425 N. Main, Suite 1, Fairview, OK 73737 | 2007-05-23 |
| 1861553703 | Dentistry for Today, P.C. | Dentist | 2414a Heritage Trail, Fairview, OK 73737 | 2006-12-13 |
| 1487727699 | State of Oklahoma | Community/Behavioral Health | Northwest Center for Behavioral Health, 1425 N. Main, Suite 1, Fairview, OK 73737 | 2006-11-16 |
| 1174519102 | Fairview Home Health LLC | Home Health | 806 N Main St, Fairview, OK 73737-1004 | 2005-09-26 |
| 1760569073 | Robert A. Marti, D.d.s., A Professional Corporation | Dentist | 917 N Main St, Fairview, OK 73737-1005 | 2006-11-01 |
| 1033579818 | Jana Lyn Hickman | Occupational Therapist | 510 Surrey Ln, Fairview, OK 73737-1006 | 2016-03-07 |
| 1831759679 | Olivers Express Pharmacy LLC | Audiologist-Hearing Aid Fitter | 624 N Main St, Fairview, OK 73737-1216 | 2019-06-14 |
| 1134545999 | Olivers Express Pharmacy LLC | Pharmacy | 624 N Main St, Fairview, OK 73737-1216 | 2014-03-17 |
| Find all providers in zip 73737 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962676270 | Joan L Turek | Physician Assistant | 35499 County Rd 134, Fairview, MT 59221 | 2008-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392868 | James Scott Turner | Physician Assistant | 924 Nw 14th St, Moore, OK 73160-1610 | 2020-09-23 |
| 1386283679 | Cody Rice Chambers | Physician Assistant | 2002 12th Ave Nw Ste B, Ardmore, OK 73401-1206 | 2020-01-03 |
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1568920924 | Direct2u Urgent Care Pllc | Physician Assistant | 2417 County Road 1263, Blanchard, OK 73010-3123 | 2019-03-05 |
| 1538625660 | Symachia LLC | Physician Assistant | 115 N. Main St., Cashion, OK 73106 | 2019-02-13 |
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1316420086 | Lauren Anto | Physician Assistant | 2824 Classen Blvd Ste 100, Norman, OK 73071-4059 | 2018-09-10 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1093240749 | Green's Country Clinic, LLC | Physician Assistant | 223 E Blackwell Ave, Blackwell, OK 74631-2909 | 2017-05-01 |
| Find all providers with the same taxonomy | ||||
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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.