Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRAD ALAN LISTON, D.O.
Active Sole ProprietorDR. BRAD ALAN LISTON, D.O. is a Adolescent Medicine healthcare provider located in PONCA CITY, Oklahoma. NPI 1487817375 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · PONCA CITY, OK
Registration Details
- NPI Number
- 1487817375
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 9, 2008 (18.116571916632 yrs)
- Last Updated
- Sep 16, 2020
- License
-
4659 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1908 N 14TH ST STE 204PONCA CITY, OK, 746012039Browse OK providers · Browse ZIP 74601
- Phone
- 5807635900
- Fax
- 5807635901
- Primary Specialty
-
Adolescent Medicine
207QA0505X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.