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General NPI Number Information
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NPI Number | 1417061771
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Entity Type | Individual
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Provider Name | RANDEL W BROWN MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 3214 E RACE AVE
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City | SEARCY
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State | AR
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Zip | 72143-4810
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Country | US
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Telephone | 877-485-4474
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Fax |
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Provider Business Mailing Address
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Address Line | 11 WORTHINGTON CT
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City | LITTLE ROCK
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State | AR
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Zip | 72223-1300
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Country | US
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Telephone | 501-952-6994
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C-7902
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License Number State | AR
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