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General NPI Number Information
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NPI Number | 1750246997
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Entity Type | Individual
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Provider Name | JACOB JAMES BROWN
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Gender | Male
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1410 N 4TH ST
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City | CLINTON
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State | IA
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Zip | 52732-2940
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Country | US
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Telephone | 563-244-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 9510 PRAIRIE CENTER RD
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City | MORRISON
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State | IL
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Zip | 61270-9359
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25494
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License Number State | IA
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