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General NPI Number Information
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NPI Number | 1851386486
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Entity Type | Individual
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Provider Name | JOHN MICHAEL BROWN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 03/08/2010
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Provider Practice Location Address
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Address Line | 3920 ST FRANCIS WAY SUITE 100
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City | LAFAYETTE
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State | IN
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Zip | 47905-4917
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Country | US
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Telephone | 765-428-5888
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Fax | 765-428-5897
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Provider Business Mailing Address
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Address Line | 3920 ST FRANCIS WAY SUITE 100
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City | LAFAYETTE
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State | IN
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Zip | 47905-4917
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Country | US
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Telephone | 765-428-5888
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Fax | 765-428-5897
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01024033A
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License Number State | IN
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