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Blue Bayou Inc
Adolescent Medicine (Family Medicine) Physician in Oklahoma City, Oklahoma
NPI 1043568538

Blue Bayou Inc is an Adolescent Medicine (Family Medicine) Physician based in Oklahoma City, OK and is specialized in Adolescent Medicine. Blue Bayou Inc practices in Oklahoma City, OK. The NPI Number for Blue Bayou Inc is 1043568538 and holds a License No. 12345 (Oklahoma).

The current practice location address for Blue Bayou Inc is 100 Park Ave, Oklahoma City, OK and can be reached out via phone at 405-229-3410.

Location: 100 Park Ave, Oklahoma City, OK, 73102-8006
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1043568538
Provider Name
Blue Bayou Inc
Credential
Provider Entity Type
Organization
Address
100 Park Ave, Oklahoma City, OK, 73102-8006
Phone Number
405-229-3410
Fax Number
Provider Enumeration Date
08/15/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
100 Park Ave
City
Oklahoma City
State
Oklahoma
Zip
73102-8006
Phone Number
405-229-3410
Fax Number
person
Provider Business Mailing Address Details
Address
100 Park Ave
City
Oklahoma City
State
Oklahoma
Zip
73102-8006
Phone Number
405-229-3410
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adolescent Medicine
Taxonomy
207QA0000X
License No.
12345 (Oklahoma)
Definition
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
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