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NPI Code Detail

MEDICARE: DR. JODY LANE BROWN M.D.

MEDICARE: DR. JODY LANE BROWN M.D.
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
12084P0804XChild & Adolescent Psychiatry PhysicianME 83675FL
22084P0804XChild & Adolescent Psychiatry PhysicianE-6072AR
32084P0800XPsychiatry PhysicianE-6072AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689660441
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JODY LANE BROWN M.D.
Provider Business Mailing Address
First Line : 4300 SW 13TH ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-4006
Country : US
Telephone Number : 352-374-5600
Fax Number :
Provider Business Practice Location Address
First Line : 4300 SW 13TH ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-4006
Country : US
Telephone Number : 352-374-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 01/19/2015

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