Basic Information
Provider Information
NPI: 1225021702
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNELL
FirstName: BRIAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14100 PARKWAY COMMONS DR STE 100
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731346036
CountryCode: US
TelephoneNumber: 4057483300
FaxNumber: 4057491671
Practice Location
Address1: 14100 PARKWAY COMMONS DR STE 100
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731346036
CountryCode: US
TelephoneNumber: 4057483300
FaxNumber: 4057491671
Other Information
ProviderEnumerationDate: 08/30/2005
LastUpdateDate: 02/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000XM2119TXN Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000X21270OKY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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