BRAD A LISTON, DO, Adult Medicine PONCA CITY, OK

Contact Information

BRAD A LISTON, DO

1908 N 14TH ST STE 204
PONCA CITY, OK 74601-2039

Phone: 580-763-5900
Fax: 580-763-5901
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Adult Medicine	207QA0505X	08	Physician/Family Practice

Indicates primary specialty

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NPI Profile & details for BRAD A LISTON · (Male)

NPI #	`1487817375`
Status	Active
Credentials	DO (Doctor of Osteopathic)
Entity	Individual
Enumeration date	07/09/2008
Last updated	09/16/2020 - About 6 years ago
Sole proprietor ¹	Yes
Identifiers	OK License # 4659
Hospital affiliation(s)	INTEGRIS BLACKWELL REGIONAL HOSPITAL - (Acute Care) 710 SOUTH 13TH STREET BLACKWELL, OK 74631 O U MEDICAL CENTER - (Acute Care) 1200 EVERETT DRIVE OKLAHOMA CITY, OK 73104 PONCA CITY MEDICAL CENTER - (Acute Care) 1900 NORTH 14TH STREET PONCA CITY, OK 74601 STILLWATER MEDICAL CENTER - (Acute Care) 1323 WEST 6TH STREET STILLWATER, OK 74076

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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BRAD A LISTON, DO – NPI #1487817375Adult Medicine

Contact Information

Specialty

Adult Medicine

NPI Profile & details for BRAD A LISTON · (Male)

Reviews for BRAD A LISTON

BRAD A LISTON, DO – NPI #1487817375
Adult Medicine