Provider Demographics
NPI:1023340338
Name:NAYLOR, BRUCE ADDIS (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ADDIS
Last Name:NAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4013 NW EXPRESSWAY
Mailing Address - Street 2:STE. 675
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-2610
Mailing Address - Country:US
Mailing Address - Phone:405-440-8970
Mailing Address - Fax:405-440-8927
Practice Address - Street 1:4013 NW EXPRESSWAY
Practice Address - Street 2:STE. 675
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-2610
Practice Address - Country:US
Practice Address - Phone:405-440-8970
Practice Address - Fax:405-440-8927
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK8299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine