Provider Demographics
NPI:1265796023
Name:ADRIAN, CELESTE COLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:COLEEN
Last Name:ADRIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:COLEEN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 N MONTE VISTA ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4676
Mailing Address - Country:US
Mailing Address - Phone:580-310-0102
Mailing Address - Fax:580-310-0104
Practice Address - Street 1:435 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4676
Practice Address - Country:US
Practice Address - Phone:580-310-0102
Practice Address - Fax:580-310-0104
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32906208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery