Provider Demographics
NPI:1275508186
Name:FREY, BRET N (MD)
Entity Type:Individual
Prefix:
First Name:BRET
Middle Name:N
Last Name:FREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:580-213-9799
Mailing Address - Fax:580-234-2474
Practice Address - Street 1:2821 N VAN BUREN ST STE A
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1729
Practice Address - Country:US
Practice Address - Phone:580-213-9799
Practice Address - Fax:580-234-2474
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK18928207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100714960BMedicaid
OK100714960BMedicaid
G70492Medicare UPIN
OK5390430001Medicare NSC
OKP00212247Medicare PIN
OK100714960BMedicaid