Provider Demographics
NPI:1932586468
Name:BRICKMAN, CAYCI L (MD)
Entity Type:Individual
Prefix:
First Name:CAYCI
Middle Name:L
Last Name:BRICKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:OKEENE
Mailing Address - State:OK
Mailing Address - Zip Code:73763-0389
Mailing Address - Country:US
Mailing Address - Phone:580-822-4404
Mailing Address - Fax:580-822-4403
Practice Address - Street 1:124 N 6TH ST
Practice Address - Street 2:
Practice Address - City:OKEENE
Practice Address - State:OK
Practice Address - Zip Code:73763-9135
Practice Address - Country:US
Practice Address - Phone:580-822-4404
Practice Address - Fax:580-822-4403
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC38429207Q00000X
OK33600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK400522415Medicaid