Healthcare Provider Details

I. General information

NPI: 1902932114
Provider Name (Legal Business Name): RICHARD JEROME BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7913 VILLAGE DR
CINCINNATI OH
45242-4313
US

IV. Provider business mailing address

7913 VILLAGE DR
CINCINNATI OH
45242-4313
US

V. Phone/Fax

Practice location:
  • Phone: 513-706-9892
  • Fax: 513-469-8389
Mailing address:
  • Phone: 513-706-9892
  • Fax: 513-469-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35. 051103
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35. 051103
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: