Provider Demographics
NPI:1154524411
Name:DAVID P. BROWN, MD PA
Entity type:Organization
Organization Name:DAVID P. BROWN, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-394-3718
Mailing Address - Street 1:1302 HIGHWAY 71 N
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-8417
Mailing Address - Country:US
Mailing Address - Phone:479-394-3718
Mailing Address - Fax:479-394-7571
Practice Address - Street 1:1302 HIGHWAY 71 N
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8417
Practice Address - Country:US
Practice Address - Phone:479-394-3718
Practice Address - Fax:479-394-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5B999Medicare ID - Type UnspecifiedGROUP MEDICAL PRACTICE