Provider Demographics
NPI:1285640771
Name:BREGMAN, RICHARD MARVIN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:MARVIN
Last Name:BREGMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:
Practice Address - Street 1:6585 S YALE AVE STE 650
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8319
Practice Address - Country:US
Practice Address - Phone:918-502-5600
Practice Address - Fax:918-502-5603
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12633207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100027650AMedicaid
OKP00475203OtherMEDICARE RR
OK100027650AMedicaid
OKP00475203OtherMEDICARE RR