Healthcare Provider Details

I. General information

NPI: 1073197968
Provider Name (Legal Business Name): TARA BROWN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA EINEICHNER

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 SOUTH AVE
LA CROSSE WI
54601-5494
US

IV. Provider business mailing address

1836 SOUTH AVE
LA CROSSE WI
54601-5494
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-7300
  • Fax:
Mailing address:
  • Phone: 608-782-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036169674
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number82302-21
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036169674
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: