Healthcare Provider Details

I. General information

NPI: 1568396281
Provider Name (Legal Business Name): FREDERICK J BROWN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE BARNES DRIVE
ST. LOUIS MO
63108
US

IV. Provider business mailing address

2742 CHARITON ST FL 1
SAINT LOUIS MO
63111-1105
US

V. Phone/Fax

Practice location:
  • Phone: 800-241-3000
  • Fax:
Mailing address:
  • Phone: 800-241-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0411321522
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: