Provider Demographics
NPI:1861466625
Name:BROWN, DAVID RANDOLPH JR (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:RANDOLPH
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11013 HEFNER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5035
Mailing Address - Country:US
Mailing Address - Phone:405-751-2020
Mailing Address - Fax:405-751-4901
Practice Address - Street 1:11013 HEFNER POINTE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5035
Practice Address - Country:US
Practice Address - Phone:405-751-2020
Practice Address - Fax:405-751-4901
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK15271207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology