Provider Demographics
NPI:1134336373
Name:MONS, BRADLEY RUSSELL (DO)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:RUSSELL
Last Name:MONS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:411 STONE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1026
Mailing Address - Country:US
Mailing Address - Phone:918-924-6275
Mailing Address - Fax:918-518-7563
Practice Address - Street 1:411 STONE WOOD DR
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1026
Practice Address - Country:US
Practice Address - Phone:918-924-6275
Practice Address - Fax:918-518-7563
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI57565207Y00000X, 207YX0007X
PAOS014959207YS0123X
OK5413207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck