Healthcare Provider Details

I. General information

NPI: 1396745121
Provider Name (Legal Business Name): PETER B BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3945 E. PARADISE FALLS DR., STE. 201
TUCSON AZ
85712
US

IV. Provider business mailing address

2202N FORBES BLVD
TUCSON AZ
85745-1412
US

V. Phone/Fax

Practice location:
  • Phone: 520-872-7130
  • Fax:
Mailing address:
  • Phone: 520-872-7536
  • Fax: 520-872-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number23509
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number23509
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: