Provider Demographics
NPI:1912076811
Name:BROWNLEE, KIRK PATRICK (OD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:PATRICK
Last Name:BROWNLEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 GOODER SIMPSON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-9237
Mailing Address - Country:US
Mailing Address - Phone:405-373-4510
Mailing Address - Fax:
Practice Address - Street 1:51 GOODER SIMPSON BLVD STE C
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078-9237
Practice Address - Country:US
Practice Address - Phone:405-373-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK 2412152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist