Provider Demographics
NPI:1215158357
Name:BROWN, WILLIAM G (PA)
Entity type:Individual
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First Name:WILLIAM
Middle Name:G
Last Name:BROWN
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Gender:M
Credentials:PA
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Mailing Address - Street 1:300 E MAIN ST
Mailing Address - Street 2:PO BOX 189
Mailing Address - City:REYNOLDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15851-1282
Mailing Address - Country:US
Mailing Address - Phone:814-375-6071
Mailing Address - Fax:814-375-6073
Practice Address - Street 1:20 INDUSTRIAL DR
Practice Address - Street 2:ACUTE CARE CLINIC
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3842
Practice Address - Country:US
Practice Address - Phone:814-375-6071
Practice Address - Fax:814-375-6073
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2011-08-10
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Provider Licenses
StateLicense IDTaxonomies
PAMA000173L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA213353Medicare PIN