Healthcare Provider Details

I. General information

NPI: 1932429354
Provider Name (Legal Business Name): BROOKE N. MCQUEEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 S YALE AVE STE 209
TULSA OK
74136-8303
US

IV. Provider business mailing address

6600 S YALE AVE STE 1400
TULSA OK
74136-3331
US

V. Phone/Fax

Practice location:
  • Phone: 918-488-0990
  • Fax: 918-728-8036
Mailing address:
  • Phone: 918-499-4855
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number33618
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: