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General NPI Number Information
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NPI Number | 1114547783
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Entity Type | Individual
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Provider Name | ERIC WAYNE BROWN CRT
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Gender | Male
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 3000 ALVEY PARK DR W STE F
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City | OWENSBORO
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State | KY
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Zip | 42303-2104
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Country | US
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Telephone | 270-683-3661
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Fax | 270-683-3662
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Provider Business Mailing Address
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Address Line | 1241 WAYSIDE DR E
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City | OWENSBORO
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State | KY
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Zip | 42301-2619
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Country | US
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Telephone | 270-231-9525
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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 | 2278E1000X
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Taxonomy Name | Educational Certified Respiratory Therapist
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License Number | 7139
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License Number State | KY
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