Individual
DR. AUSTIN TANNER BROOKOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
5657 S MADISON AVE, TULSA, OK 74105-7712
(918) 706-4922
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6370
OK
261QS1000X
Student Health Clinic/Center
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2017
Last updated
06/05/2020
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