Healthcare Provider Details

I. General information

NPI: 1659597524
Provider Name (Legal Business Name): DEREK JOSEPH BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 12TH AVE STE 301C
EMPORIA KS
66801-2589
US

IV. Provider business mailing address

1201 W 12TH AVE
EMPORIA KS
66801-2504
US

V. Phone/Fax

Practice location:
  • Phone: 620-340-6164
  • Fax: 620-341-7766
Mailing address:
  • Phone: 620-343-6800
  • Fax: 620-341-7821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number036-117704
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-34047
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: