Provider Demographics
NPI:1407084791
Name:WILSON, BRADLEY ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ALLEN
Last Name:WILSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:500 E ROBINSON SUITE 1300
Mailing Address - Street 2:NORMAN UROLOGY ASSOCIATES, PC
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6694
Mailing Address - Country:US
Mailing Address - Phone:405-360-9966
Mailing Address - Fax:405-360-9905
Practice Address - Street 1:500 E ROBINSON SUITE 1300
Practice Address - Street 2:NORMAN UROLOGY ASSOCIATES, PC
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6694
Practice Address - Country:US
Practice Address - Phone:405-360-9966
Practice Address - Fax:405-360-9905
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2014-07-21
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Provider Licenses
StateLicense IDTaxonomies
OK30538208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology