Provider Demographics
NPI:1063524163
Name:BROWN, KEVIN F (DO)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:F
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 FM 1960 W
Mailing Address - Street 2:230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090
Mailing Address - Country:US
Mailing Address - Phone:877-749-7428
Mailing Address - Fax:281-724-3100
Practice Address - Street 1:9630 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6267
Practice Address - Country:US
Practice Address - Phone:480-551-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA131505208100000X
AZ005311208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM74454536Medicaid
NM345532101Medicare PIN
NM74454536Medicaid
NMP00269936Medicare PIN