Healthcare Provider Details

I. General information

NPI: 1588900955
Provider Name (Legal Business Name): ALYCIA M BROWN, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 S MAIN ST SUITE 202
GRAHAM NC
27253-3734
US

IV. Provider business mailing address

845 S MAIN ST SUITE 202
GRAHAM NC
27253-3734
US

V. Phone/Fax

Practice location:
  • Phone: 336-222-0095
  • Fax: 336-228-0703
Mailing address:
  • Phone: 336-222-0095
  • Fax: 336-228-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number88754
License Number StateNC

VIII. Authorized Official

Name: JOANNE L EURE
Title or Position: BILLING COORDINATOR
Credential:
Phone: 336-662-8185