MEDICARE: DR. CLARKE DOUGLAS BROWN P.T.,A.T.C.,D.P.T.

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	174400000X	Specialist	8672	NY

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	:	1912966003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLARKE DOUGLAS BROWN P.T.,A.T.C.,D.P.T.

Provider Business Mailing Address
First Line	:	4396 KIPP RD
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-8312
Country	:	US
Telephone Number	:	585-396-3344
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 ROUTE 31
Second Line	:	WEST WAYNE PLAZA
City	:	MACEDON
State	:	NY
Zip	:	14502-8943
Country	:	US
Telephone Number	:	315-986-4655
Fax Number	:

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	03/12/2008

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