MEDICARE: CHAD MICHAEL BROWN PA-C

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	PA163717	OR

General Provider Information

NPI Number	:	1326333519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD MICHAEL BROWN PA-C

Provider Business Mailing Address
First Line	:	149 CLEAR CREEK DR UNIT 108
Second Line	:
City	:	ASHLAND
State	:	OR
Zip	:	97520-1882
Country	:	US
Telephone Number	:	541-414-3808
Fax Number	:	949-404-6159

Provider Business Practice Location Address
First Line	:	149 CLEAR CREEK DR UNIT 108
Second Line	:
City	:	ASHLAND
State	:	OR
Zip	:	97520-1882
Country	:	US
Telephone Number	:	541-414-3808
Fax Number	:

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

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	11/14/2022

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