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Dr. Brad Alan Liston, DO
Adult Medicine Physician in Ponca City, Oklahoma
NPI 1487817375

Brad Alan Liston is an Adult Medicine Physician based in Ponca City, OK and is specialized in Adult Medicine. Brad Alan Liston practices in Ponca City, OK and has the professional credentials of DO. The NPI Number for Brad Alan Liston is 1487817375 and holds a License No. 4659 (Oklahoma).

The current practice location address for Brad Alan Liston is 1908 N 14Th St Ste 204, Ponca City, OK and can be reached out via phone at 580-763-5900 and via fax at 580-763-5901.

Location: 1908 N 14Th St Ste 204, Ponca City, OK, 74601-2039
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487817375
Provider Name
Brad Alan Liston
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1908 N 14Th St Ste 204, Ponca City, OK, 74601-2039
Phone Number
580-763-5900
Fax Number
580-763-5901
Provider Enumeration Date
07/09/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1908 N 14Th St Ste 204
City
Ponca City
State
Oklahoma
Zip
74601-2039
Phone Number
580-763-5900
Fax Number
580-763-5901
person
Provider Business Mailing Address Details
Address
1908 N 14Th St Ste 204
City
Ponca City
State
Oklahoma
Zip
74601-2039
Phone Number
580-763-5900
Fax Number
580-763-5901
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
4659 (Oklahoma)
Definition
Definition to come.
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