Healthcare Provider Details

I. General information

NPI: 1245233972
Provider Name (Legal Business Name): STEVEN L BROWN AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 S MOUNT AUBURN RD
CAPE GIRARDEAU MO
63703-4918
US

IV. Provider business mailing address

262 S MOUNT AUBURN RD
CAPE GIRARDEAU MO
63703-4918
US

V. Phone/Fax

Practice location:
  • Phone: 573-651-3404
  • Fax: 573-651-0035
Mailing address:
  • Phone: 573-651-3404
  • Fax: 573-651-0035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01168
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: