MEDICARE: DR. RYANNE ELIZABETH ELMER BROWN O.D.

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	2838	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588049456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYANNE ELIZABETH ELMER BROWN O.D.

Provider Business Mailing Address
First Line	:	11013 HEFNER POINTE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-5035
Country	:	US
Telephone Number	:	405-751-2020
Fax Number	:	405-751-3838

Provider Business Practice Location Address
First Line	:	3011 NW 63RD ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116
Country	:	US
Telephone Number	:	405-840-2800
Fax Number	:	405-840-8242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	06/29/2018

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