MEDICARE: DR. KEVIN DOUGLAS BROWN D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	07001001A	IN
2	213ES0103X	Foot & Ankle Surgery Podiatrist	00282	KY
3	213ES0103X	Foot & Ankle Surgery Podiatrist	10396	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1699732214	OTHER	WV	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811968555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN DOUGLAS BROWN D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 4100
Second Line	:
City	:	BARBOURSVILLE
State	:	WV
Zip	:	25504-4100
Country	:	US
Telephone Number	:	304-955-6200
Fax Number	:	304-399-2526

Provider Business Practice Location Address
First Line	:	2828 1ST AVE
Second Line	:	400
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1236
Country	:	US
Telephone Number	:	304-525-6905
Fax Number	:	304-525-6154

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	12/05/2022

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Directions to “ DR. KEVIN DOUGLAS BROWN D.P.M.” Practice Location

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