OrganizationActive
Blue Bayou Inc
NPI 1043568538 · Adolescent Medicine (Family Medicine) Physician · Oklahoma City, OK
Provider details
- NPI number
- 1043568538
- Entity type
- Organization
- Primary specialty
- Adolescent Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- James Bronson, Ceo
- License
- 12345 (OK)
Mailing address
100 Park Ave
Oklahoma City, OK 73102-8006
Registry dates
- Enumerated
- 2012-08-15
- Last updated
- 2012-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.