Provider Demographics
NPI:1558717553
Name:VALANTINE, BRANDON (DO)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:VALANTINE
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 1:14100 PARKWAY COMMONS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6104
Mailing Address - Country:US
Mailing Address - Phone:405-749-2765
Mailing Address - Fax:405-749-6209
Practice Address - Street 1:14100 PARKWAY COMMONS DR STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6104
Practice Address - Country:US
Practice Address - Phone:405-749-2765
Practice Address - Fax:405-749-6209
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6886207LP2900X, 208VP0014X
KS9408883207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology