Provider Demographics
NPI:1306031216
Name:DR. BRIAN L .FLOURNOY, P.C.
Entity Type:Organization
Organization Name:DR. BRIAN L .FLOURNOY, P.C.
Other - Org Name:DR. BRIAN L. FLOURNOY, P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:FLOURNOY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-728-8800
Mailing Address - Street 1:3314 E 46TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2926
Mailing Address - Country:US
Mailing Address - Phone:918-728-8800
Mailing Address - Fax:918-728-8801
Practice Address - Street 1:3314 E 46TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2926
Practice Address - Country:US
Practice Address - Phone:918-728-8800
Practice Address - Fax:918-728-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1639261670OtherNPI
OK=========OtherTAX ID NUMBER
OK1639261670OtherNPI
OK=========OtherTAX ID NUMBER