Provider Demographics
NPI:1003375577
Name:BRAUMILLER, ALLEN SPOONER III
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:SPOONER
Last Name:BRAUMILLER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-2726
Mailing Address - Country:US
Mailing Address - Phone:405-800-6303
Mailing Address - Fax:
Practice Address - Street 1:100 S 79TH ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-2726
Practice Address - Country:US
Practice Address - Phone:405-800-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist