MEDICARE: DR. JONATHAN M 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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	4060	AZ
2	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	20220531	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1184651580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN M BROWN DO

Provider Business Mailing Address
First Line	:	601 E 14TH ST
Second Line	:
City	:	SEDALIA
State	:	MO
Zip	:	65301-5972
Country	:	US
Telephone Number	:	660-826-5226
Fax Number	:	660-826-5246

Provider Business Practice Location Address
First Line	:	3700 W 10TH ST STE 300
Second Line	:
City	:	SEDALIA
State	:	MO
Zip	:	65301-2540
Country	:	US
Telephone Number	:	660-826-5226
Fax Number	:	660-826-5246

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	03/22/2023

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Directions to “ DR. JONATHAN M BROWN DO” Practice Location

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