Organization
BROOKE K STOUGH DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKE KELLEY STOUGH DPM (PODIATRIST/OWNER)
(405) 210-8071
Entity
Organization
Contact information
Practice address
1113 WINCHESTER AVE, ENID, OK 73703-8401
(405) 210-8071
Mailing address
1113 WINCHESTER AVE, ENID, OK 73703-8401
(405) 210-8071
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
297
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200441760A
—
OK
Enumeration date
11/12/2012
Last updated
11/12/2012
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