Birdwell, Brian Gillam

Birdwell, Brian Gillam is an individual health care provider with primary practice located at 4202 Sw Lee Blvd , Lawton OK 73505-8300. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Birdwell, Brian Gillam can be contacted via phone (580) 248-9966.

Contact Information

Primary practice address
4202 Sw Lee Blvd Lawton OK 73505-8300
Phone: (580) 248-9966
Fax: (580) 248-8313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 13900 Oklahoma
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X 13900 Oklahoma
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 13900 Oklahoma

Profile Details

NPI number 1013909605
LBN Legal business name Birdwell, Brian Gillam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Dec 22nd, 2011 - about 13 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 1013909605 NPPES
Oklahoma MEDICAID 100824240

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