Provider Demographics
NPI:1063417970
Name:BROWN, MONICA ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-272-5395
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:4121 DUTCHMANS LN STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4753
Practice Address - Country:US
Practice Address - Phone:502-899-6700
Practice Address - Fax:502-899-6740
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35037207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64082621Medicaid
KYK010861OtherMEDICARE PTAN - WOMEN'S SPECIALISTS
KY000000675542OtherANTHEM
KY50030074OtherPASSPORT
KY64082621Medicaid
KYK010861OtherMEDICARE PTAN - WOMEN'S SPECIALISTS