Blue Bayou Inc

Organization Adolescent Medicine (Family Medicine) Physician · NPI 1043568538

Blue Bayou Inc is an Adolescent Medicine (Family Medicine) Physician in Oklahoma City, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2012.

Licensed in: OK
In the registry since: 2012

What do these letters mean?

Inc — Incorporated: A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 Park Ave
Oklahoma City, OK 73102-8006
Phone: (405) 229-3410

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adolescent Medicine (Family Medicine) Physician (primary)	Taxonomy 207QA0000X · Licence 12345 (OK)

Record details

NPI number	1043568538
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	James Bronson — Ceo · (405) 229-3410
NPI enumerated	August 15, 2012
Last updated in NPPES	September 18, 2012
Mailing address	100 Park Ave, Oklahoma City, OK 73102-8006