Healthcare Provider Details

I. General information

NPI: 1265974182
Provider Name (Legal Business Name): ROBERT J. BROWNSBERGER, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 N LEROUX ST
FLAGSTAFF AZ
86001-3225
US

IV. Provider business mailing address

2451 S WHITE MOUNTAIN RD
SHOW LOW AZ
85901-7306
US

V. Phone/Fax

Practice location:
  • Phone: 928-774-3919
  • Fax: 928-774-2076
Mailing address:
  • Phone: 928-774-3919
  • Fax: 928-774-2076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: ROBERT BROWNSBERGER
Title or Position: OWNER
Credential: M.D.
Phone: 928-774-3919