Provider Demographics
NPI:1285740001
Name:JOSEPH BROWN III, MD
Entity type:Organization
Organization Name:JOSEPH BROWN III, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:757-220-0557
Mailing Address - Street 1:224 MONTICELLO AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6430
Mailing Address - Country:US
Mailing Address - Phone:757-220-0557
Mailing Address - Fax:757-229-9907
Practice Address - Street 1:224 MONTICELLO AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6430
Practice Address - Country:US
Practice Address - Phone:757-220-0557
Practice Address - Fax:757-229-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101014389207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
052892OtherANTHEM
VA5604214Medicaid
829-155OtherUNITED HEALTH
B10056Medicare UPIN
VA5604214Medicaid