MEDICARE: JOSEPH 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	363A00000X	Physician Assistant	PA.0006382	CO

General Provider Information

NPI Number	:	1558654103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MICHAEL BROWN PA-C

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIR
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	254-220-2978
Fax Number	:	915-569-4890

Provider Business Practice Location Address
First Line	:	7136 BUCKOAK CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80927-4018
Country	:	US
Telephone Number	:	254-220-2978
Fax Number	:	915-569-4890

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

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	01/26/2021

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