Healthcare Provider Details

I. General information

NPI: 1770875478
Provider Name (Legal Business Name): TAYLOR BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 FOREST PARK AVE DIV SURG ONCOLOGY, 5TH FL
SAINT LOUIS MO
63108-2114
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-2280
  • Fax: 888-352-8360
Mailing address:
  • Phone: 314-362-2280
  • Fax: 888-352-8360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2019026717
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number2019026717
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: