Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 34129 | OK |
NPI | 1003253410 |
---|---|
Provider Name | Patrick Bronson Reeves |
First Address | Oklahoma City, OK 73112-4489 |
Second Address | Oklahoma City, OK 73112-4489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2013 |
Last Update Date | 11/01/2019 |