MEDICARE: DR. DENNIS AUGUSTUS 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	208000000X	Pediatrics Physician	153831	NY
2	208000000X	Pediatrics Physician	051438	GA

General Provider Information

NPI Number	:	1154320505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS AUGUSTUS BROWN M.D.

Provider Business Mailing Address
First Line	:	904 BACON RD
Second Line	:
City	:	HINESVILLE
State	:	GA
Zip	:	31313-4800
Country	:	US
Telephone Number	:	646-772-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 HARMON AVE
Second Line	:	WINN ARMY COMMUNITY HOSPITAL, PEDIATRIC CLINIC
City	:	FT STEWART
State	:	GA
Zip	:	31314-5604
Country	:	US
Telephone Number	:	912-435-5555
Fax Number	:	912-435-5050

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/08/2007

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