Healthcare Provider Details

I. General information

NPI: 1699858043
Provider Name (Legal Business Name): RICHARD D. BROWN MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 OKLAHOMA AVE
WOODWARD OK
73801-4357
US

IV. Provider business mailing address

1502 OKLAHOMA AVE
WOODWARD OK
73801-4357
US

V. Phone/Fax

Practice location:
  • Phone: 589-256-5100
  • Fax: 580-256-5429
Mailing address:
  • Phone: 589-256-5100
  • Fax: 580-256-5429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14404
License Number StateOK

VIII. Authorized Official

Name: RICHARD DENNIS BROWN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 580-256-5100