1871897918 NPI number — NANCY A BROWN, DO, PC

Table of content: (NPI 1871897918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871897918 NPI number — NANCY A BROWN, DO, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NANCY A BROWN, DO, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871897918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2120 MCKOWN DR
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73072-6683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-364-8501
Provider Business Mailing Address Fax Number:
405-364-8535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2120 MCKOWN DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73072-6683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-364-8501
Provider Business Practice Location Address Fax Number:
405-364-8535
Provider Enumeration Date:
01/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
405-364-8501

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  2849 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A44436003881 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 660002388 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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