Healthcare Provider Details
I. General information
NPI: 1225250939
Provider Name (Legal Business Name): J DAVID BROWN DPM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3011 S LINDSAY RD #113
GILBERT AZ
85295
US
IV. Provider business mailing address
3011 S LINDSAY RD #113
GILBERT AZ
85295
US
V. Phone/Fax
- Phone: 480-759-6737
- Fax: 480-759-5404
- Phone: 480-759-6737
- Fax: 480-759-5404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
J
DAVID
BROWN
Title or Position: OWNER
Credential: DPM
Phone: 480-759-6737