Healthcare Provider Details

I. General information

NPI: 1134863541
Provider Name (Legal Business Name): JAMES MICHAEL BROWN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 SAINT JOSEPH LN
LONDON KY
40741-8345
US

IV. Provider business mailing address

PO BOX 936
LONDON KY
40743-0936
US

V. Phone/Fax

Practice location:
  • Phone: 606-330-2377
  • Fax: 606-330-2369
Mailing address:
  • Phone: 606-330-7835
  • Fax: 606-330-2369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05960
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: