MEDICARE: MELANIE PAIGE-BROWN

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	122300000X	Dentist	2743	MS
2	1223G0001X	General Practice Dentistry	2743-93	MS

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

General Provider Information

NPI Number	:	1649210477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE PAIGE-BROWN

Provider Business Mailing Address
First Line	:	989 ELLIS AVE
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39209
Country	:	US
Telephone Number	:	601-354-3557
Fax Number	:	601-354-7191

Provider Business Practice Location Address
First Line	:	989 ELLIS AVE
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39209-6256
Country	:	US
Telephone Number	:	601-354-3557
Fax Number	:

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/21/2022

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Directions to “ MELANIE PAIGE-BROWN ” Practice Location

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