Provider Demographics
NPI:1285606798
Name:BROWN, DAVID C (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W HORTON ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-3607
Mailing Address - Country:US
Mailing Address - Phone:260-824-0800
Mailing Address - Fax:260-824-7243
Practice Address - Street 1:100 W HORTON ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-3607
Practice Address - Country:US
Practice Address - Phone:260-824-0800
Practice Address - Fax:260-824-7243
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000345A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100257480Medicaid
IN234760WMedicare PIN
IN370640BMedicare ID - Type Unspecified
IN911660BMedicare ID - Type Unspecified
IN371310BMedicare ID - Type Unspecified
IN100257480Medicaid