Individual
ELIZABETH ARYN BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
118 W COMMERCIAL ST, BROKEN ARROW, OK 74012-4011
(918) 893-3520
(918) 893-3538
Mailing address
2401 SOUTHWEST BLVD, TULSA, OK 74107-2726
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5191
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200442660B
—
OK
01
—
714970
MEDICARE
OK
Enumeration date
04/13/2011
Last updated
11/12/2019
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