Provider Demographics
NPI:1477639920
Name:BJORNSON, VICTORIA WILHELM (DO)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:WILHELM
Last Name:BJORNSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74129-1620
Mailing Address - Country:US
Mailing Address - Phone:918-622-0641
Mailing Address - Fax:918-622-0683
Practice Address - Street 1:9912 E 21ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-1620
Practice Address - Country:US
Practice Address - Phone:918-622-0641
Practice Address - Fax:918-622-0683
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine