Provider Demographics
NPI:1588086490
Name:REMY, BRUCE KEVIN (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:KEVIN
Last Name:REMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 CEDAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3153
Mailing Address - Country:US
Mailing Address - Phone:405-360-4436
Mailing Address - Fax:
Practice Address - Street 1:1828 CEDAR HILL RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3153
Practice Address - Country:US
Practice Address - Phone:405-360-4436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14508208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice