Healthcare Provider Details

I. General information

NPI: 1316918691
Provider Name (Legal Business Name): DAVID E. BROWN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 MOUNT SAINT MARYS DR
NELSONVILLE OH
45764-1280
US

IV. Provider business mailing address

PO BOX 65274
CHARLOTTE NC
28265-0274
US

V. Phone/Fax

Practice location:
  • Phone: 740-753-1931
  • Fax: 740-753-3177
Mailing address:
  • Phone: 800-377-8721
  • Fax: 304-523-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34-00-1855-B
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: