Provider Demographics
NPI:1194795385
Name:BROWNSBERGER, ROBERT JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:BROWNSBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N LEROUX ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3253
Mailing Address - Country:US
Mailing Address - Phone:928-774-3919
Mailing Address - Fax:928-774-2076
Practice Address - Street 1:705 N LEROUX ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3253
Practice Address - Country:US
Practice Address - Phone:928-774-3919
Practice Address - Fax:928-774-2076
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ234292081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ320763Medicaid
F42409Medicare UPIN
AZ320763Medicaid
AZZ145019Medicare PIN