Provider Demographics
NPI:1437788452
Name:RAWLINSON, BRANDON EDWARD (DO)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:EDWARD
Last Name:RAWLINSON
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 1:11402 N 135TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5701
Mailing Address - Country:US
Mailing Address - Phone:918-212-7373
Mailing Address - Fax:
Practice Address - Street 1:11402 N 135TH EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5701
Practice Address - Country:US
Practice Address - Phone:918-212-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7347207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine