MEDICARE: BROWNLEE OPTOMETRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OK2412	OK

General Provider Information

NPI Number	:	1174693279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWNLEE OPTOMETRY PLLC

Provider Business Mailing Address
First Line	:	51 GOODER SIMPSON BLVD STE C
Second Line	:
City	:	PIEDMONT
State	:	OK
Zip	:	73078-9237
Country	:	US
Telephone Number	:	405-373-4310
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 GOODER SIMPSON BLVD.
Second Line	:	STE. C
City	:	PIEDMONT
State	:	OK
Zip	:	73078
Country	:	US
Telephone Number	:	405-373-4510
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KIRK PATRICK BROWNLEE
Credential	:	O.D.
Telephone Number	:	405-373-4510

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	09/10/2024

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