Healthcare Provider Details
I. General information
NPI: 1568753739
Provider Name (Legal Business Name): CAROLYNN STARR FRANCAVILLA BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/22/2011
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 UNION BLVD ST 311
LAKEWOOD CO
80228-1830
US
IV. Provider business mailing address
200 UNION BLVD SUITE 311
LAKEWOOD CO
80228-1830
US
V. Phone/Fax
- Phone: 303-566-7170
- Fax:
- Phone: 303-566-7170
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 51619 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QB0002X |
| Taxonomy | Obesity Medicine (Family Medicine) Physician |
| License Number | 51619 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: