Provider Demographics
NPI:1811215056
Name:BRANSON KESTER MEDICINE PLC
Entity Type:Organization
Organization Name:BRANSON KESTER MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANSON
Authorized Official - Middle Name:R
Authorized Official - Last Name:KESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-307-1000
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-307-6646
Mailing Address - Fax:405-307-6660
Practice Address - Street 1:901 N PORTER
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6404
Practice Address - Country:US
Practice Address - Phone:405-307-6646
Practice Address - Fax:405-307-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25191207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1134260201OtherINDIVIDUAL NPI