Healthcare Provider Details

I. General information

NPI: 1275565079
Provider Name (Legal Business Name): VICTORIA ANN BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 4TH ST 2ND FLOOR
LEBANON PA
17046-5606
US

IV. Provider business mailing address

PO BOX 300
LEBANON PA
17042-0300
US

V. Phone/Fax

Practice location:
  • Phone: 717-274-0474
  • Fax: 717-274-0673
Mailing address:
  • Phone: 717-270-7780
  • Fax: 717-274-9746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD045500E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD045500E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: