Healthcare Provider Details

I. General information

NPI: 1174523740
Provider Name (Legal Business Name): PEGGY J BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 MARION ST
SEARCY AR
72143-4845
US

IV. Provider business mailing address

609 MARION ST
SEARCY AR
72143-4845
US

V. Phone/Fax

Practice location:
  • Phone: 501-278-5610
  • Fax: 501-278-5614
Mailing address:
  • Phone: 501-278-5610
  • Fax: 501-278-5614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberN8082
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: