Individual
AUSTIN LANE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1725 E 19TH ST STE 800, TULSA, OK 74104-5464
(918) 301-2505
Mailing address
11380 S 282ND EAST AVE, COWETA, OK 74429-5013
(918) 906-2175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4657
OK
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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