Provider Demographics
NPI:1720248164
Name:ROEHL, BRYAN CHRISTOPHER (DO)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:CHRISTOPHER
Last Name:ROEHL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8210
Practice Address - Street 1:6465 S YALE AVE STE 605
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7808
Practice Address - Country:US
Practice Address - Phone:918-502-4040
Practice Address - Fax:918-502-4045
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4434207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200182920AMedicaid