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General NPI Number Information
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NPI Number | 1083614291
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Entity Type | Individual
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Provider Name | DAVID EDWARD BROWN D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 250 SE 15TH RD
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City | LAMAR
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State | MO
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Zip | 64759-9272
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Country | US
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Telephone | 417-681-5284
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Fax | 417-681-5505
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Provider Business Mailing Address
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Address Line | PO BOX 607
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City | LAMAR
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State | MO
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Zip | 64759-0607
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Country | US
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Telephone | 913-904-8446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | KS0520825
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R8707
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License Number State | MO
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