Basic Information
| Provider Information | |||||||||
| NPI: | 1083118749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BESCH | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 N WALKER AVE APT 9108 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731021876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082153551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 940 STANTON L YOUNG BLVD | ||||||||
| Address2: | BMSB 451 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052712451 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2018 | ||||||||
| LastUpdateDate: | 06/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 38189 | OK | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.