Provider Demographics
NPI:1295391175
Name:CORLEE, N BRYCE ANDREW (DPM)
Entity Type:Individual
Prefix:
First Name:N BRYCE
Middle Name:ANDREW
Last Name:CORLEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-2006
Mailing Address - Country:US
Mailing Address - Phone:405-418-2676
Mailing Address - Fax:405-418-2677
Practice Address - Street 1:100 SE 59TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-3616
Practice Address - Country:US
Practice Address - Phone:405-635-3028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH59.000845213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist