Provider Demographics
NPI:1578730685
Name:WHITE, BRAD AARON (DO)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:AARON
Last Name:WHITE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:6009 W CHARLESTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-1483
Mailing Address - Country:US
Mailing Address - Phone:405-747-0133
Mailing Address - Fax:918-748-7688
Practice Address - Street 1:1611 S UTICA AVE
Practice Address - Street 2:BOX 217
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4909
Practice Address - Country:US
Practice Address - Phone:918-744-3664
Practice Address - Fax:918-748-7688
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2014-02-08
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Provider Licenses
StateLicense IDTaxonomies
OK4696207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology