Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 20714 | OK |
N | 225400000X | Rehabilitation Practitioner | 20714 | OK |
NPI | 1063444974 |
---|---|
Provider Name | Dr. Michael Scott Brown |
First Address | Oklahoma City, OK 73120-9322 |
Second Address | Oklahoma City, OK 73120-9322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 18/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G47068 | (02) |