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General NPI Number Information
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NPI Number | 1184651580
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Entity Type | Individual
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Provider Name | JONATHAN M BROWN DO
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 3700 W 10TH ST STE 300
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City | SEDALIA
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State | MO
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Zip | 65301-2540
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Country | US
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Telephone | 660-826-5226
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Fax | 660-826-5246
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Provider Business Mailing Address
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Address Line | 601 E 14TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5972
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Country | US
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Telephone | 660-826-5226
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Fax | 660-826-5246
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 4060
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 20220531
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License Number State | MO
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