Provider Demographics
NPI:1376684167
Name:CLAFLIN, BRANDON SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:SCOTT
Last Name:CLAFLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9308 S TOLEDO AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2739
Mailing Address - Country:US
Mailing Address - Phone:918-728-8020
Mailing Address - Fax:918-728-8019
Practice Address - Street 1:9308 S TOLEDO AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2739
Practice Address - Country:US
Practice Address - Phone:918-728-8020
Practice Address - Fax:918-728-8019
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK48542081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200299940AMedicaid
OKOKAAA1259Medicare PIN