Provider Demographics
NPI:1063770212
Name:KNIGHT-BROWN, MIRANDA DAWN (MD)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:DAWN
Last Name:KNIGHT-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:DAWN
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18385 COUNTY ROAD 1548
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-3055
Mailing Address - Country:US
Mailing Address - Phone:918-360-4620
Mailing Address - Fax:
Practice Address - Street 1:807 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-7711
Practice Address - Country:US
Practice Address - Phone:580-332-8855
Practice Address - Fax:580-332-7374
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK390200000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology