Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 23047 | OK |
NPI | 1023167798 |
---|---|
Provider Name | Dr. Brian Alan Link |
First Address | Oklahoma City, OK 73134-1785 |
Second Address | Oklahoma City, OK 73120-8366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 03/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23047 | OK LICENSE (01) | OK |
32642 | OBNDD (01) | OK |