Individual
KENNETH W BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
825 NE 10TH ST, OUPB5200, OKLAHOMA CITY, OK 73104-5417
(405) 271-7770
Mailing address
1122 NE 13TH ST, ORI 236, OKLAHOMA CITY, OK 73117-1039
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
510
OK
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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