Provider Demographics
NPI:1376503102
Name:HAYMORE, BRET RICE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRET
Middle Name:RICE
Last Name:HAYMORE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8121 NATIONAL AVE
Mailing Address - Street 2:STE 309
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7572
Mailing Address - Country:US
Mailing Address - Phone:405-628-3666
Mailing Address - Fax:405-272-4027
Practice Address - Street 1:4716 W URBANA ST
Practice Address - Street 2:SUITE 211
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5997
Practice Address - Country:US
Practice Address - Phone:918-994-5200
Practice Address - Fax:918-994-5222
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2016-09-22
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Provider Licenses
StateLicense IDTaxonomies
OK28286207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200424280AMedicaid