Provider Demographics
NPI:1497769566
Name:BROWNELL, AMY COLLEEN (DO)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:COLLEEN
Last Name:BROWNELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:A
Other - Middle Name:C
Other - Last Name:BROWNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2813 KINGSTON CT
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-7446
Mailing Address - Country:US
Mailing Address - Phone:918-331-9601
Mailing Address - Fax:
Practice Address - Street 1:3500 E FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2411
Practice Address - Country:US
Practice Address - Phone:918-331-1555
Practice Address - Fax:918-331-1695
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4125207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK20009073AMedicaid
OK20009073AMedicaid
OKOK700837Medicare PIN