Healthcare Provider Details

I. General information

NPI: 1821301987
Provider Name (Legal Business Name): ROBERT JEFFREY BROWN PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2010
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SPARKS AVE
JEFFERSONVILLE IN
47130-3732
US

IV. Provider business mailing address

211 SPARKS AVE
JEFFERSONVILLE IN
47130-3732
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-3413
  • Fax:
Mailing address:
  • Phone: 812-282-3413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08000297A
License Number StateIN

VIII. Authorized Official

Name: DR. ROBERT JEFFREY BROWN
Title or Position: PRESIDENT
Credential: DC
Phone: 812-282-3413