Provider Demographics
NPI:1447299151
Name:BROWN, KATHRYN C (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9311 S MINGO RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5702
Mailing Address - Country:US
Mailing Address - Phone:918-307-1613
Mailing Address - Fax:918-307-2454
Practice Address - Street 1:9311 S MINGO RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5702
Practice Address - Country:US
Practice Address - Phone:918-307-1613
Practice Address - Fax:918-307-2454
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK25938207KI0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH99438Medicare UPIN
NY5N7631Medicare ID - Type Unspecified