Provider Demographics
NPI:1104882414
Name:BARBARA A. BROWN
Entity type:Organization
Organization Name:BARBARA A. BROWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN APPLEGATE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:785-346-2033
Mailing Address - Street 1:128 S 5TH ST
Mailing Address - Street 2:PO BOX 307
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-2304
Mailing Address - Country:US
Mailing Address - Phone:785-346-2033
Mailing Address - Fax:785-346-2919
Practice Address - Street 1:128 S 5TH ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-2304
Practice Address - Country:US
Practice Address - Phone:785-346-2033
Practice Address - Fax:785-346-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500690363A00000X
KS0523287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100359250AMedicaid
KS016867Medicare ID - Type Unspecified