Healthcare Provider Details
I. General information
NPI: 1275018145
Provider Name (Legal Business Name): ROBERT J. BROWNSBERGER MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2018
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
203 S CANDY LN STE 2A
COTTONWOOD AZ
86326-4172
US
IV. Provider business mailing address
3769 CROSSINGS DR STE D
PRESCOTT AZ
86305-7121
US
V. Phone/Fax
- Phone: 928-532-7599
- Fax: 928-532-5899
- Phone: 928-774-3191
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
JOSEPH
BROWNSBERGER
Title or Position: PRESIDENT
Credential:
Phone: 928-774-3919