MEDICARE: DORIS J TRIBUNE BROWN DO

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	207Q00000X	Family Medicine Physician	2003004232	MO

General Provider Information

NPI Number	:	1174572762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIS J TRIBUNE BROWN DO

Provider Business Mailing Address
First Line	:	670 MASON RIDGE CENTER DR
Second Line	:	STE 300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8573
Country	:	US
Telephone Number	:	314-831-6883
Fax Number	:	314-831-3716

Provider Business Practice Location Address
First Line	:	1225 GRAHAM RD
Second Line	:	SUITE 2320C
City	:	FLORISSANT
State	:	MO
Zip	:	63031-8012
Country	:	US
Telephone Number	:	314-831-6883
Fax Number	:	314-831-3716

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	09/26/2025

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