Provider Demographics
NPI:1972888741
Name:BRADFORD, SUMMER DAWN
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:DAWN
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SUMMER
Other - Middle Name:DAWN
Other - Last Name:SUAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-4429
Mailing Address - Country:US
Mailing Address - Phone:918-587-9471
Mailing Address - Fax:
Practice Address - Street 1:102 N DENVER AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1806
Practice Address - Country:US
Practice Address - Phone:918-582-1200
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator