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NPI Code Detail

MEDICARE: KEVIN LEE BROWN

MEDICARE: KEVIN LEE BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1427528611
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN LEE BROWN
Provider Business Mailing Address
First Line : 1268 ELECTRIC AVE
Second Line :
City : SPRINGDALE
State : AR
Zip : 72764-7498
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1268 ELECTRIC AVE
Second Line :
City : SPRINGDALE
State : AR
Zip : 72764-7498
Country : US
Telephone Number : 479-387-0305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2018
Last Update Date : 05/24/2024

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