Provider Demographics
NPI:1780919308
Name:WHEELER, BRETT DOUGLAS (BA)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:DOUGLAS
Last Name:WHEELER
Suffix:
Gender:
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-1415
Mailing Address - Country:US
Mailing Address - Phone:405-537-2228
Mailing Address - Fax:
Practice Address - Street 1:3817 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-1415
Practice Address - Country:US
Practice Address - Phone:405-537-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20274171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator