Provider Demographics
NPI:1083974836
Name:BAUER, BRIAN J (MSN)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:BAUER
Suffix:
Gender:M
Credentials:MSN
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Mailing Address - Street 1:500 E ROBINSON ST
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6697
Mailing Address - Country:US
Mailing Address - Phone:405-364-6432
Mailing Address - Fax:405-928-7513
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:SUITE 2600
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-364-6432
Practice Address - Fax:405-928-7513
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2014-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK93020363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200436340AMedicaid