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NPI Code Detail

MEDICARE: JAYNE HENDERSON BROWN M.D.

MEDICARE: JAYNE HENDERSON BROWN M.D.
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
1207R00000XInternal Medicine PhysicianMD044009EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083653505
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYNE HENDERSON BROWN M.D.
Provider Business Mailing Address
First Line : 432 N 6TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-4004
Country : US
Telephone Number : 215-925-2400
Fax Number : 215-925-9162
Provider Business Practice Location Address
First Line : 4510 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19124-3602
Country : US
Telephone Number : 215-744-1302
Fax Number : 215-744-2544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 03/22/2012

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