Provider Demographics
NPI:1821375171
Name:BRADLEY-WALKER, ELIZABETH ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:BRADLEY-WALKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:6622 S 112TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2629
Mailing Address - Country:US
Mailing Address - Phone:918-850-2850
Mailing Address - Fax:918-286-8988
Practice Address - Street 1:6140 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1933
Practice Address - Country:US
Practice Address - Phone:918-252-2020
Practice Address - Fax:918-307-1983
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist