Provider Demographics
NPI:1154905776
Name:BROWN, JORDAN STANFORD RASHAD (DO)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:STANFORD RASHAD
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 1:16 ARMS BLVD APT 11
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-2756
Mailing Address - Country:US
Mailing Address - Phone:440-522-8529
Mailing Address - Fax:
Practice Address - Street 1:EAST LIVERPOOL CITY HOSPITAL
Practice Address - Street 2:425 W. FIFTH STREET
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920
Practice Address - Country:US
Practice Address - Phone:330-385-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58032500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine