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General NPI Number Information
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NPI Number | 1306840640
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Entity Type | Individual
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Provider Name | JEFFREY R BROWN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 445 SOUTH MAIN STREET
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City | WEST HARTFORD
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State | CT
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Zip | 06110
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Country | US
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Telephone | 860-561-7111
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Fax | 860-561-7272
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Provider Business Mailing Address
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Address Line | 445 SOUTH MAIN STREET
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City | WEST HARTFORD
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State | CT
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Zip | 06110
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Country | US
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Telephone | 860-561-7111
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Fax | 860-561-7272
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 041435
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 041435
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License Number State | CT
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