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NPI Code Detail

MEDICARE: TERRY ALLEN BROWN MD

MEDICARE: TERRY ALLEN BROWN MD
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
1207Q00000XFamily Medicine Physician183868-1205UT

General Provider Information

NPI Number : 1679510614
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY ALLEN BROWN MD
Provider Business Mailing Address
First Line : PO BOX 307
Second Line :
City : BOUNTIFUL
State : UT
Zip : 84011-0307
Country : US
Telephone Number : 801-294-6907
Fax Number : 801-294-6917
Provider Business Practice Location Address
First Line : 441 S REDWOOD RD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84104-3539
Country : US
Telephone Number : 801-973-2588
Fax Number : 801-973-6985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 06/22/2010

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