Healthcare Provider Details

I. General information

NPI: 1780598508
Provider Name (Legal Business Name): MARGARET LEIGH BREWER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WEATHERWOOD WAY
BRISTOW OK
74010-2671
US

IV. Provider business mailing address

406 N 3RD AVE
STROUD OK
74079-3409
US

V. Phone/Fax

Practice location:
  • Phone: 918-367-3551
  • Fax:
Mailing address:
  • Phone: 870-847-2208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: