MEDICARE: DR. DAVID EDWARD BROWN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	KS0520825	KS
2	208600000X	Surgery Physician	R8707	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	120000760	OTHER	KS	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	057860	OTHER	KS	BCBS OF KS
2	431270614	OTHER	KS	TRIWEST
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	25662015	OTHER	MO	BCBS OF KC(IND)
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	25661017	OTHER	MO	BCBS OF KC(GRP)

General Provider Information

NPI Number	:	1083614291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID EDWARD BROWN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 607
Second Line	:
City	:	LAMAR
State	:	MO
Zip	:	64759-0607
Country	:	US
Telephone Number	:	913-904-8446
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 SE 15TH RD
Second Line	:
City	:	LAMAR
State	:	MO
Zip	:	64759-9272
Country	:	US
Telephone Number	:	417-681-5284
Fax Number	:	417-681-5505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/05/2015

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Directions to “ DR. DAVID EDWARD BROWN D.O.” Practice Location

Language	Start Address	Practice Location

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