Healthcare Provider Details

I. General information

NPI: 1619947546
Provider Name (Legal Business Name): ALAN BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTHEAST IOWA PATHOLOGY ASSOCIATES, PC 1825 LOGAN AVENUE
WATERLOO IA
50703
US

IV. Provider business mailing address

NORTHEAST IOWA PATHOLOGY ASSOCIATES, PC PO BOX 2818
WATERLOO IA
50704-2818
US

V. Phone/Fax

Practice location:
  • Phone: 319-235-3679
  • Fax: 319-233-0722
Mailing address:
  • Phone: 319-233-3044
  • Fax: 319-233-0722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number27676
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: