Provider Demographics
NPI:1871615757
Name:MURRAY, BRYCE WARREN (MD)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:WARREN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 E 81ST ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4250
Mailing Address - Country:US
Mailing Address - Phone:918-505-3400
Mailing Address - Fax:918-508-7070
Practice Address - Street 1:2448 E 81ST ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4250
Practice Address - Country:US
Practice Address - Phone:918-505-3400
Practice Address - Fax:918-508-7070
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28277208600000X
FLME115051390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200337230BMedicaid
OK200337230BMedicaid