Provider Demographics
NPI:1477871531
Name:SIMIC, CHRIS BRIAN (D O)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:BRIAN
Last Name:SIMIC
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13815 S 27TH CT
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3868
Mailing Address - Country:US
Mailing Address - Phone:816-810-0088
Mailing Address - Fax:
Practice Address - Street 1:13815 S 27TH CT
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3868
Practice Address - Country:US
Practice Address - Phone:816-810-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2364207P00000X
OK5029207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine