Provider Demographics
NPI:1063591857
Name:BROWN, DOUGLAS THORBURN (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:THORBURN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:ATTEN CHRISTIE MSS
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7350
Mailing Address - Country:US
Mailing Address - Phone:207-351-2478
Mailing Address - Fax:207-351-2153
Practice Address - Street 1:2929 5TH STREET
Practice Address - Street 2:240
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7338
Practice Address - Country:US
Practice Address - Phone:605-341-3770
Practice Address - Fax:605-341-8692
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME0147382084N0400X
SD83082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME241180099Medicaid
ME241180099Medicaid