Healthcare Provider Details

I. General information

NPI: 1962129114
Provider Name (Legal Business Name): BROWNS FAMILY MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 HIGHWAY 2
WARNER OK
74469-2302
US

IV. Provider business mailing address

PO BOX 679
WARNER OK
74469-0679
US

V. Phone/Fax

Practice location:
  • Phone: 918-463-2095
  • Fax: 918-675-5050
Mailing address:
  • Phone: 918-463-2095
  • Fax: 918-463-2097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE BROWN
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 918-463-2095