Healthcare Provider Details

I. General information

NPI: 1043506751
Provider Name (Legal Business Name): BROOKE L. STORER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 05/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13921 N. MERIDIAN AVE. STE 200
OKLAHOMA CITY OK
73134-1104
US

IV. Provider business mailing address

13921 N. MERIDIAN AVE. STE 200
OKLAHOMA CITY OK
73134-1104
US

V. Phone/Fax

Practice location:
  • Phone: 405-755-7430
  • Fax: 405-755-6319
Mailing address:
  • Phone: 405-755-7430
  • Fax: 405-755-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number28529
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: