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NPI Code Detail

MEDICARE: DR. GREGORY MARK BROWN M.D.

MEDICARE: DR. GREGORY MARK 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
1207R00000XInternal Medicine PhysicianME0058899FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
212567OTHERFLBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1386647956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY MARK BROWN M.D.
Provider Business Mailing Address
First Line : 619 W DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-2602
Country : US
Telephone Number : 352-314-2424
Fax Number : 352-314-3010
Provider Business Practice Location Address
First Line : 619 W DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-2602
Country : US
Telephone Number : 352-314-2424
Fax Number : 352-314-3010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 04/02/2015

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