Provider Demographics
NPI:1710279724
Name:BARRICK, BRETT ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:ALLEN
Last Name:BARRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 E 21ST ST STE 320
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1722
Mailing Address - Country:US
Mailing Address - Phone:918-392-4547
Mailing Address - Fax:918-392-4555
Practice Address - Street 1:2424 E 21ST ST STE 320
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1722
Practice Address - Country:US
Practice Address - Phone:918-392-4547
Practice Address - Fax:918-392-4555
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127315207X00000X
OK32931207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018403900Medicaid
FLIU106ZMedicare PIN