BROWN, STACY SUZANNE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

BROWN, STACY SUZANNE

This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.

Practice Address:	GREAT PLAINS REGIONAL MEDICAL CENTER 1710 W 3RD STREET SUITE 103 ELK CITY OK 73644 Address last updated on 3/9/2024
Phone #:	(405) 427-3705
Fax #:	(405) 427-3738
County:	BECKHAM
License:	1182
Dated:	4/1/2002
Expires:	3/31/2025
Temp. Ltr. Issued:	1/3/2002
Temp. Ltr. Expires:	3/31/2002
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
GREAT PLAINS REGIONAL MEDICAL CENTER 1710 W 3RD STREET SUITE 103 ELK CITY OK 73644 Phone #: (405) 427-3705 Fax #: (405) 427-3738

Hospital Privileges:

Great Plains Regional Medical Center
Elk City, OK

Name:	Type:	License Number:
Primary Supervisor(s):
Grant Detten	DO	6969
S. Riley Winham	DO	6073

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