Provider Demographics
NPI:1578821930
Name:BROWN, ELI KONTEE' III
Entity Type:Individual
Prefix:MR
First Name:ELI
Middle Name:KONTEE'
Last Name:BROWN
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 N QUANAH AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-2705
Mailing Address - Country:US
Mailing Address - Phone:918-760-4890
Mailing Address - Fax:
Practice Address - Street 1:2316 N QUANAH AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-2705
Practice Address - Country:US
Practice Address - Phone:918-760-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health