Provider Demographics
NPI:1427462050
Name:HADEL, BRANDON (OD)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:HADEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 S GATEWAY PLACE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037
Mailing Address - Country:US
Mailing Address - Phone:918-747-2020
Mailing Address - Fax:918-747-2056
Practice Address - Street 1:244 S GATEWAY PLACE
Practice Address - Street 2:SUITE 401
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037
Practice Address - Country:US
Practice Address - Phone:918-747-2020
Practice Address - Fax:918-747-2056
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2851152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist