Healthcare Provider Details

I. General information

NPI: 1740260942
Provider Name (Legal Business Name): JAMES WELLINGTON BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 SUGAR MAPLE DR 88 MDG/SGQXN
WRIGHT PATTERSON AFB OH
45433-5546
US

IV. Provider business mailing address

PO BOX 848
FAIRBORN OH
45324-0848
US

V. Phone/Fax

Practice location:
  • Phone: 937-257-9678
  • Fax: 937-257-9680
Mailing address:
  • Phone: 937-257-9678
  • Fax: 937-257-9680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number00013762
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License NumberME22265
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: