Healthcare Provider Details

I. General information

NPI: 1891807814
Provider Name (Legal Business Name): CAROLYN VIRDEN BROWN MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 JORDAN AVE
JUNEAU AK
99801-8050
US

IV. Provider business mailing address

2231 JORDAN AVE
JUNEAU AK
99801-8050
US

V. Phone/Fax

Practice location:
  • Phone: 907-789-1812
  • Fax: 907-789-7168
Mailing address:
  • Phone: 907-789-1812
  • Fax: 907-789-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number907
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: