MEDICARE: DR. COBY THOMAS 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
1	207V00000X	Obstetrics & Gynecology Physician	9362887-1205	UT

General Provider Information

NPI Number	:	1083907059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COBY THOMAS BROWN M.D.

Provider Business Mailing Address
First Line	:	295 S 1470 E STE 200
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-1762
Country	:	US
Telephone Number	:	435-628-1662
Fax Number	:	435-628-1722

Provider Business Practice Location Address
First Line	:	295 S 1470 E STE 200
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84790-1762
Country	:	US
Telephone Number	:	435-628-1662
Fax Number	:	435-628-1722

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

Provider Enumeration Date	:	05/24/2011
Last Update Date	:	07/14/2020

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