Healthcare Provider Details

I. General information

NPI: 1760479745
Provider Name (Legal Business Name): W L BROWN MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 E SPRUCE AVE C
FRESNO CA
93720-3374
US

IV. Provider business mailing address

1221 E SPRUCE AVE C
FRESNO CA
93720-3374
US

V. Phone/Fax

Practice location:
  • Phone: 559-265-4444
  • Fax: 559-265-4454
Mailing address:
  • Phone: 559-265-4444
  • Fax: 559-265-4454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIE L BROWN JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 559-265-4444