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NPI Code Detail

MEDICARE: DR. JOHN DOUGLAS BROWN M.D.

MEDICARE: DR. JOHN DOUGLAS 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
1207Q00000XFamily Medicine Physician11278NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00892340OTHERNVRAILROAD MEDICARE

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 : 1306865837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN DOUGLAS BROWN M.D.
Provider Business Mailing Address
First Line : PO BOX 98978
Second Line :
City : LAS VEGAS
State : NV
Zip : 89193-8978
Country : US
Telephone Number : 702-507-2419
Fax Number : 702-671-6883
Provider Business Practice Location Address
First Line : 1302 W CRAIG RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0246
Country : US
Telephone Number : 702-657-9555
Fax Number : 702-657-9040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 01/26/2012

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