Johnston, Willis Bradley

Johnston, Willis Bradley is an individual health care provider with primary practice located at 701 Ne 10Th St , Oklahoma City OK 73104-5403. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Johnston, Willis Bradley can be contacted via phone (405) 280-5550.

Contact Information

Primary practice address
701 Ne 10Th St Oklahoma City OK 73104-5403
Phone: (405) 280-5550
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 132 Oklahoma

Profile Details

NPI number 1881660025
LBN Legal business name Johnston, Willis Bradley
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated May 2nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881660025 NPPES
Oklahoma MEDICAID 100780620A

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