Healthcare Provider Details

I. General information

NPI: 1033438817
Provider Name (Legal Business Name): BROWN COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 VANDAMENT WAY
MT ORAB OH
45154-8395
US

IV. Provider business mailing address

111 VANDAMENT WAY
MT ORAB OH
45154-8395
US

V. Phone/Fax

Practice location:
  • Phone: 937-444-6750
  • Fax: 937-444-6751
Mailing address:
  • Phone: 937-444-6750
  • Fax: 937-444-6751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL C. PATTERSON
Title or Position: CEO
Credential:
Phone: 937-378-7501