Provider Demographics
NPI:1437363702
Name:BRYAN, JONATHAN A (DO)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:A
Last Name:BRYAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:950 N PORTER AVE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6410
Mailing Address - Country:US
Mailing Address - Phone:405-329-0121
Mailing Address - Fax:405-321-0121
Practice Address - Street 1:950 N PORTER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6400
Practice Address - Country:US
Practice Address - Phone:405-329-0121
Practice Address - Fax:405-292-6099
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4706207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine