Individual
STACY S. BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3115 SW 89TH ST, OKLAHOMA CITY, OK 73159-7901
(405) 427-3705
(405) 427-3738
Mailing address
14024 QUAIL POINTE DR, OKLAHOMA CITY, OK 73134-1006
(405) 419-8465
(405) 419-7745
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1182
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097540A
—
OK
01
—
P00878500
MEDICARE RAILROAD
OK
Enumeration date
12/01/2005
Last updated
07/14/2021
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