MEDICARE: DR. WILLIAM HERBERT BROWN JR. D.D.S.

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	1223G0001X	General Practice Dentistry	2167	WV

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	2167	OTHER	WV	ST. BOARD NUMBER
3	55-0580354	OTHER	WV	FEIN

General Provider Information

NPI Number	:	1376564773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM HERBERT BROWN JR. D.D.S.

Provider Business Mailing Address
First Line	:	519 6TH ST
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-2012
Country	:	US
Telephone Number	:	304-522-1310
Fax Number	:

Provider Business Practice Location Address
First Line	:	519 6TH ST
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-2012
Country	:	US
Telephone Number	:	304-522-1310
Fax Number	:

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. WILLIAM HERBERT BROWN JR. D.D.S.” Practice Location

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