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Individual

DR. LAUREN BROOKS SOUTHWARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
(580) 223-9114
Mailing address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
(580) 223-5051

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21988
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100850310B
OK
Enumeration date
11/28/2005
Last updated
03/04/2021
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