Provider Demographics
NPI:1063429892
Name:BROWN, JAMES M (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1491 HEALTH CENTER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6767
Mailing Address - Country:US
Mailing Address - Phone:405-806-2200
Mailing Address - Fax:405-806-2207
Practice Address - Street 1:1491 HEALTH CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6767
Practice Address - Country:US
Practice Address - Phone:405-806-2200
Practice Address - Fax:405-806-2207
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4047207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00393116OtherRAILROAD MEDICARE
OK200053570AMedicaid
OKP00393116OtherRAILROAD MEDICARE
OK245520001Medicare PIN