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NPI Code Detail

MEDICARE: J. COREY BROWN, PLLC

MEDICARE: J. COREY BROWN, PLLC
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
1208D00000XGeneral Practice Physician2950NV

General Provider Information

NPI Number : 1518261544
Entity Type Code : Organization
Provider Name (Legal Business Name) : J. COREY BROWN, PLLC
Provider Business Mailing Address
First Line : 4880 WYNN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5406
Country : US
Telephone Number : 702-430-3820
Fax Number : 702-222-0645
Provider Business Practice Location Address
First Line : 4880 WYNN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-5406
Country : US
Telephone Number : 702-430-3820
Fax Number : 702-222-0645
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JANICE K ECKES
Credential : R.N.
Telephone Number : 702-430-3820
Provider Enumeration Date : 01/05/2011
Last Update Date : 01/05/2011

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