Healthcare Provider Details

I. General information

NPI: 1457278921
Provider Name (Legal Business Name): THOMAS MICHAEL BROCK APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E ROBINSON ST STE 2300
NORMAN OK
73071-6671
US

IV. Provider business mailing address

PO BOX 115
NORMAN OK
73070-0115
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-1780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number229889
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: