BJT MD PLLC

Organization Active NPI Obstetrics & Gynecology Physician · Moore, OK

NPI 1992960231 · NPPES record last updated Apr 24, 2012

Key facts

NPI
1992960231
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
23781 (OK)
Legal business name
BJT MD PLLC
Practice address
1035 SW 19TH St
Suite B
Moore, OK 73160-2883
Phone
(405) 793-9171
Fax
(405) 793-0815
NPI assigned
Jul 25, 2008
Organization subpart
No

Authorized official

Name
Dr. Bryan J Treacy, MD
Title
Owner/Physician
Phone
(405) 793-9171

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1035 SW 19th St
Ste B
Moore, OK 73160
Phone (405) 793-9171

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X 23781 OK Yes

Addresses

Primary practice location

1035 SW 19TH St
Suite B
Moore, OK 73160-2883

Mailing address

PO Box 6847
Moore, OK 73153-0847
Phone (405) 793-9171

Other identifiers

IdentifierTypeStateIssuer
200263670AMedicaidOK

Other names

  • Bryan J Treacy, MD LLC Doing business as

Other providers in Moore, OK

All providers in Moore, OK · Obstetrics & Gynecology Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.