Provider Demographics
NPI:1417157462
Name:BROWN, RONALD D (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-3446
Mailing Address - Country:US
Mailing Address - Phone:405-528-1936
Mailing Address - Fax:405-521-8260
Practice Address - Street 1:1801 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-3446
Practice Address - Country:US
Practice Address - Phone:405-528-1936
Practice Address - Fax:405-521-8260
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor