Healthcare Provider Details

I. General information

NPI: 1770683294
Provider Name (Legal Business Name): HARRY H BROWN O.D., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST UAMS DEPT. OF PATHOLOGY #517
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

311 CRYSTAL CT
LITTLE ROCK AR
72205-4231
US

V. Phone/Fax

Practice location:
  • Phone: 501-526-7507
  • Fax:
Mailing address:
  • Phone: 501-663-6236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberN7615
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: