Provider Demographics
NPI:1407131667
Name:BROWN, CASSIE LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:610 SW 52ND ST
Mailing Address - Street 2:APT. 106
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6837
Mailing Address - Country:US
Mailing Address - Phone:570-574-3155
Mailing Address - Fax:
Practice Address - Street 1:4301 WILSON ST
Practice Address - Street 2:ATTN: RUBY PRESCOTT
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-4472
Practice Address - Country:US
Practice Address - Phone:580-558-2134
Practice Address - Fax:580-558-2314
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG002513152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist