Healthcare Provider Details
I. General information
NPI: 1356320881
Provider Name (Legal Business Name): JOSEPH A BROWN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/12/2006
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16000 JOHNSTON MEMORIAL DRIVE SUITE 304
ABINGDON VA
24211
US
IV. Provider business mailing address
16000 JOHNSTON MEMORIAL DRIVE SUITE 304
ABINGDON VA
24211
US
V. Phone/Fax
- Phone: 276-258-3600
- Fax: 276-258-3605
- Phone: 276-258-3600
- Fax: 276-258-3605
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 0101-234846 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101234846 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: