Healthcare Provider Details

I. General information

NPI: 1962323055
Provider Name (Legal Business Name): UROLOGY SPECIALISTS OF CENTRAL OKLAHOMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 N PORTLAND AVE STE 440
OKLAHOMA CITY OK
73112-2082
US

IV. Provider business mailing address

5401 N PORTLAND AVE STE 440
OKLAHOMA CITY OK
73112-2082
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-1153
  • Fax:
Mailing address:
  • Phone: 405-943-1153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY MICHELL BROWER
Title or Position: ADMINISTRATOR
Credential:
Phone: 405-943-1153