Healthcare Provider Details

I. General information

NPI: 1326033531
Provider Name (Legal Business Name): STUART K BROWN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 N 1ST ST
DENNISON OH
44621-1003
US

IV. Provider business mailing address

819 N 1ST ST
DENNISON OH
44621-1003
US

V. Phone/Fax

Practice location:
  • Phone: 740-922-7450
  • Fax: 740-922-8042
Mailing address:
  • Phone: 740-922-7450
  • Fax: 740-922-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34006255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: